Individual
DR. FARID BOUALAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS
Contact information
Practice address
65 E WADSWORTH PARK DR STE 230, DRAPER, UT 84020-8096
(385) 308-8034
Mailing address
65 E WADSWORTH PARK DR STE 230, DRAPER, UT 84020-8096
(385) 308-8034
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
040.0134584
VT
225100000X
Physical Therapist
Primary
26485
MD
Other
Enumeration date
05/24/2017
Last updated
05/30/2023
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