Healthcare Provider Details

I. General information

NPI: 1275454761
Provider Name (Legal Business Name): ADRENA SOMERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 N 1075 W
FARMINGTON UT
84025-2745
US

IV. Provider business mailing address

1401 N 1075 W
FARMINGTON UT
84025-2745
US

V. Phone/Fax

Practice location:
  • Phone: 801-897-8711
  • Fax:
Mailing address:
  • Phone: 801-897-8711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number14296075-4701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: