| NPI | 1093810251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE ACEVEDO Director 801-979-4722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: UT 6002870-0160) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-08-22 |