Performance Golf & Wellness Clinic

NPI 1093731754 - Physical Therapist - 225100000X

NPI Details
NPI 1093731754
Enumeration Date 07/14/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name HENRY HENRY
Position OWNER
Phone (801) 746-8997
Fax (801) 746-8996
Practice Location
1285 GUNN AVE
SALT LAKE CITY UT, 84106-3039, US
Phone (801) 746-8997
Fax (801) 746-8996
Business Location
PO BOX 307
BOUNTIFUL UT, 84011-0307, US
Phone (888) 700-6907
Fax (801) 294-6917
Toxanomy
Taxonomy Code 225100000X
License State Utah
License Number 325159-2401
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According to our database, Performance Golf & Wellness Clinic NPI is 1093731754, taxonomy code is 225100000X and license number is 325159-2401, license state is located at Utah. Performance Golf & Wellness Clinic physically located at 1285 Gunn Ave, Salt Lake City UT, 84106-3039. NPI Number 1033115704 has the healthcare provider type.

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1093731754 NPI number is provided on an as is basis without warranty of any kind. 1093731754 is maintained by the National Plan & Provider Enumeration System. The contents of Performance Golf & Wellness Clinic are for informational purposes only.