| NPI | 1073345682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON DANIELSON Physical Therapist 801-450-0008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2024-11-13 |