Healthcare Provider Details

I. General information

NPI: 1760396501
Provider Name (Legal Business Name): DAVID ANDREW WEBER LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 22ND ST
OGDEN UT
84401-1701
US

IV. Provider business mailing address

765 22ND ST
OGDEN UT
84401-1701
US

V. Phone/Fax

Practice location:
  • Phone: 208-716-3994
  • Fax:
Mailing address:
  • Phone: 208-716-3994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number142711924701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: