| NPI | 1538549993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ORMOND Owner 801-856-6368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 352304-1205) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: UT 7376354-2401) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2016-04-08 |