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1427572627
MACKENZIE BOOTH
PROVO, UT
NPI
1427572627
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2081S0010X Physical Medicine & Rehabilitation Sports Medicine
(Licence: UT 10312376-4810)
Enumeration Date
2017-07-29
Last Update Date
2017-07-29
Business Address
MACKENZIE BOOTH ATC
1120 SFH BRIGHAM YOUNG UNIVERSITY
PROVO, UT 84602
Phone number: 801-866-6082
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Mailing Address
MACKENZIE BOOTH ATC
859 HOLROYD DR
OGDEN, UT 84403-4512
Phone number: 801-866-6082
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