| 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 |