Organization
EMPOWERED REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERAMIE D. GAILLARD DPT (REGISTERED AGENT)
(801) 803-9800
Entity
Organization
Contact information
Practice address
4487 SEBAGO WAY, SOUTH JORDAN, UT 84095-5690
(801) 803-9800
(801) 803-9801
Mailing address
4487 SEBAGO WAY, SOUTH JORDAN, UT 84095-5690
(801) 803-9800
(801) 803-9801
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
5908308-2401
UT
Other
Enumeration date
02/20/2008
Last updated
08/28/2008
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