Individual
JUSTIN LANE KITCHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1284 E CENTER ST, SPANISH FORK, UT 84660-2319
(458) 219-5874
Mailing address
1284 E CENTER ST, SPANISH FORK, UT 84660-2319
(458) 219-5874
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6267176-2401
UT
Other
Enumeration date
08/26/2010
Last updated
07/27/2023
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