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NPI Code Detail

MEDICARE: ADALYN ALLEN

MEDICARE: ADALYN ALLEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist137257174701UT
2225700000XMassage Therapist

General Provider Information

NPI Number : 1558131367
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADALYN ALLEN
Provider Business Mailing Address
First Line : 3441 W 6975 S
Second Line :
City : WEST JORDAN
State : UT
Zip : 84084-1728
Country : US
Telephone Number : 801-814-4046
Fax Number :
Provider Business Practice Location Address
First Line : 9221 S REDWOOD RD STE B
Second Line :
City : WEST JORDAN
State : UT
Zip : 84088-5803
Country : US
Telephone Number : 801-814-4046
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2024
Last Update Date : 08/20/2024

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Directions to “ ADALYN ALLEN ” Practice Location

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