| NPI | 1235321811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN BLACK Director 801-619-3670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251N0400X Physical Therapist Neurology (Licence: UT 120890-2401) |
| Additional Taxonomies | 2251N0400X Physical Therapist Neurology (Licence: UT 352686-2401) |
| 225X00000X Occupational Therapist (Licence: UT 801-479-0601) | |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2020-04-13 |