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Organization
MALANA LLC
Active
Organization
MALANA LLC
Active
Other names
MINT Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY ALLEN KLEMETSON DPT (PHYSICAL THERAPIST)
(801) 735-7585
Entity
Organization
Contact information
Practice address
6247 W REUBEN CIR, WEST VALLEY CITY, UT 84128-7515
(801) 735-7585
Mailing address
6247 W REUBEN CIR, WEST VALLEY CITY, UT 84128-7515
(801) 735-7585
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/04/2021
Last updated
05/04/2021
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