Healthcare Provider Details

I. General information

NPI: 1477498871
Provider Name (Legal Business Name): DANCECORE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 N 1890 W
PROVO UT
84601-1322
US

IV. Provider business mailing address

726 N 1890 W
PROVO UT
84601-1322
US

V. Phone/Fax

Practice location:
  • Phone: 385-309-0885
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN BURTENSHAW
Title or Position: OWNER
Credential:
Phone: 385-254-1152