| NPI | 1255746400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER LEROY NELSON President/Physician 801-878-7356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2014-06-26 |