| Organization Name: | WORKSITE WELLNESS |
| NPI Number: | 1013958479 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERIC DELOYQ ROBERTS (CEO) |
| Mailing Address: | 2520 W 4700 S Taylorsville |
| State: | UT US |
| Postal Code: | 841181847 |
| Phone Number: | 8015996412 |
| Fax Number: | 8019642435 |
| NPI Enumeration Date: | 06/09/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251N0400X |
| License Number: | 4734414-2401 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Neurology |
| Taxonomy Definition: | |