NPI | 1740788876 |
---|---|
Entity Type | Organization |
Authorized Contact | JACOB DUANE REESOR Owner 801-641-6571 |
Organization Subpart ? | No |
Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: UT 10668583-1202) |
Enumeration Date | 2018-01-23 |
Last Update Date | 2018-01-23 |