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Organization
LIFE REHABILITATION, LC
Active
Organization
LIFE REHABILITATION, LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBYN ANN SMITH COTA/L, CLWT, CLT (OWNER, MANAGING PARTNER)
(801) 993-1110
Entity
Organization
Contact information
Practice address
8134 S SUMMIT VALLEY DR, WEST JORDAN, UT 84088-5930
(801) 993-1110
Mailing address
8134 S SUMMIT VALLEY DR, WEST JORDAN, UT 84088-5930
(801) 993-1110
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
83587964202
UT
Other
Enumeration date
11/02/2015
Last updated
11/02/2015
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