Healthcare Provider Details
I. General information
NPI: 1184549925
Provider Name (Legal Business Name): VITAL LYMPHATIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1160 S STATE ST STE 270
OREM UT
84097-8267
US
IV. Provider business mailing address
364 BAYSIDE DR # 270
SARATOGA SPRINGS UT
84045-8149
US
V. Phone/Fax
- Phone: 801-888-7729
- Fax:
- Phone: 801-888-7729
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRYNNLEY
PYNE
Title or Position: OWNER
Credential: LMT, MLD-C
Phone: 801-888-7729