| NPI | 1164619078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLAS LAYNE CLARK Owner/Physical Therapist 435-946-3512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY 802) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2007-09-25 |