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1063865699
BRIDGER PARK
PROVO, UT
NPI
1063865699
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2251X0800X Physical Therapist Orthopedic
(Licence: UT 3095297-8016)
Enumeration Date
2016-07-19
Last Update Date
2016-07-19
Business Address
BRIDGER PARK DPT
1034 NORTH 500 WEST
PROVO, UT 84604
Phone number: 801-357-1250
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Mailing Address
BRIDGER PARK DPT
1034 NORTH 500 WEST
PROVO, UT 84604
Phone number: 801-357-1250
Copy
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