| NPI | 1447696331 |
|---|---|
| Doing Business As | BODYLOGICMD OF SALT LAKE CITY |
| Entity Type | Organization |
| Authorized Contact | LESLIE WERDER COOPER Owner / Doctor 866-654-7013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: UT 5614879-1205) |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2013-05-17 |