| NPI | 1578082954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS K SIDWELL President 801-618-7903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2017-09-16 |
| Last Update Date | 2020-03-10 |