| NPI | 1972005791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY WHITAKER Office Manager 801-317-1618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2024-08-20 |