Organization
INJURY RECOVERY SPECIALISTS
Active
Parent organization
PRALINE CORP
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRALINE CORP
Authorized official
DR. TOM GRANT JR. DC (MANAGER)
(801) 376-9596
Entity
Organization
Contact information
Practice address
1437 W MIDAS CREEK DR, SOUTH JORDAN, UT 84095-7879
(801) 376-9596
(801) 907-7574
Mailing address
1437 W MIDAS CREEK DR, SOUTH JORDAN, UT 84095-7879
(801) 376-9596
(801) 907-7574
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
6715760-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
07/11/2014
Last updated
07/11/2014
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