| NPI | 1518654730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE PAYNE Credentialing Manager 435-999-0912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2024-02-26 |