Individual
LANCE DAVID WILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5770 S 250 E STE G50, MURRAY, UT 84107-6165
(801) 314-5002
Mailing address
5770 S 250 E STE G50, MURRAY, UT 84107-6165
(801) 314-5002
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
121641-2401
UT
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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