| NPI | 1255360434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY D FULLMER Physical Therapist/Owner 801-572-0690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: UT 5192) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-08-22 |