Organization
PERFORMANCE GOLF & WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY WHITE M.P.T (OWNER)
(801) 746-8997
Entity
Organization
Contact information
Practice address
1285 GUNN AVE, SALT LAKE CITY, UT 84106-3039
(801) 746-8997
(801) 746-8996
Mailing address
PO BOX 307, BOUNTIFUL, UT 84011-0307
(888) 700-6907
(801) 294-6917
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
325159-2401
UT
Other
Enumeration date
07/14/2006
Last updated
08/22/2020
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