Individual
MATT J LONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
6246 S REDWOOD RD, BENNION CARE CENTER, SLC, UT 84123
(801) 969-1420
(801) 955-2540
Mailing address
5997 S 200 E, SLC, UT 84107
(801) 573-7561
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D3244
—
UT
Enumeration date
11/21/2006
Last updated
07/08/2007
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