Organization
WORKSITE WELLNESS
Active
Organization
WORKSITE WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC DELOYQ ROBERTS MSPT (CEO)
(801) 599-6412
Entity
Organization
Contact information
Practice address
2520 W 4700 S, TAYLORSVILLE, UT 84118-1847
(801) 599-6412
(801) 964-2435
Mailing address
249 N MAIN ST, NORTH SALT LAKE, UT 84054-2438
(801) 599-6412
(801) 964-2435
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
4734414-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
518960747001
—
UT
Enumeration date
06/09/2006
Last updated
08/22/2020
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