Individual
GLENN BONA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
170 N 1100 E, AMERICAN FORK, UT 84003-2096
(801) 855-3437
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
103974-2401
UT
Other
Enumeration date
06/11/2007
Last updated
07/08/2007
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