| NPI | 1073933966 |
|---|---|
| Doing Business As | PEAK PERFORMANCE SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JESSICA JACOBSEN TIDSWELL President 801-718-5378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: UT 5080663-2401) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2014-05-01 |