Organization
SKYLINE SPORTS AND HUMAN PERFORMANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREG M BOSSHARDT DC (OWNER)
(435) 592-2043
Entity
Organization
Contact information
Practice address
320 S 50 W, EPHRAIM, UT 84627-4023
(435) 592-2043
Mailing address
320 S 50 W, EPHRAIM, UT 84627-4023
(435) 592-2043
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8303581-1202
UT
Other
Enumeration date
06/16/2012
Last updated
06/16/2012
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