| NPI | 1720322084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN GIVONE Director 801-990-1959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 278061-2401) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: UT 7617767-4701) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |