| NPI | 1538337837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERAMIE D. GAILLARD Registered Agent 801-803-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: UT 5908308-2401) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2008-08-28 |