| NPI | 1326064874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORDELL E PETERSON Manager 801-397-4340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 51508480144) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2020-08-22 |