| NPI | 1417347113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROCK KEITH CHRISTENSEN Occupational Therapist 435-512-9071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: UT 92879094201) |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health (Licence: UT 92879094201) |
| 261QM1300X Clinic/Center Multi-Specialty (Licence: UT 92879094201) | |
| 314000000X Skilled Nursing Facility (Licence: UT 92879094201) | |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-02-02 |