| NPI | 1538422324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE R BLAKE Administrator 801-755-9186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: UT 7272273-0160) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2012-08-06 |