| NPI | 1558631531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY RUSSELL PETERSON Owner 801-972-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: UT 1737001202) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |