| NPI | 1154801058 |
|---|---|
| Doing Business As | PERFORMANCE SPORT & SPINE |
| Entity Type | Organization |
| Authorized Contact | JARED WADSWORTH Owner 801-235-9944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: UT 10320622-1202) |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2018-08-20 |