Individual
SUMMER YACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3895 HARRISON BLVD, OGDEN, UT 84403-2312
(801) 387-3600
Mailing address
10028 S 2200 W, SOUTH JORDAN, UT 84095-9349
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10196114-2402
UT
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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