| NPI | 1740785294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA SUE TOMLIN Office Manager 801-905-1928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 111N00000X Chiropractor |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2018-03-27 |