| NPI | 1689813446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DAVID SMITH Physician/Owner 801-302-0280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician |
| Additional Taxonomies | 111NS0005X Chiropractor Sports Physician (Licence: UT 5188785-1202) |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2009-09-09 |