| NPI | 1124114038 |
|---|---|
| Doing Business As | CENTER FOR PERFORMANCE AND LONGEVITY |
| Entity Type | Organization |
| Authorized Contact | CARL KENT HEBDON Medical Director 801-547-1991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: UT 160845-1205) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2008-09-17 |