Healthcare Provider Details

I. General information

NPI: 1255265617
Provider Name (Legal Business Name): MCKALA FARNSWORTH LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8541 S REDWOOD RD STE D
WEST JORDAN UT
84088-9327
US

IV. Provider business mailing address

1217 S 200 E
SPANISH FORK UT
84660-2456
US

V. Phone/Fax

Practice location:
  • Phone: 385-831-1204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number14242546-4701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: