| NPI | 1992357933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRT FORAKIS CEO 801-610-7283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2019-07-10 |