| NPI | 1407100639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY C JACKSON Owner 801-687-3957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: UT 5370898-1202) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: UT 6077621-4701) |
| 225700000X Massage Therapist (Licence: UT 8407908-4701) | |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2023-12-07 |