Healthcare Provider Details

I. General information

NPI: 1689325771
Provider Name (Legal Business Name): SAMANTHA OWNSBEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA LASATER

II. Dates (important events)

Enumeration Date: 01/11/2022
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date: 01/25/2026
Reactivation Date: 02/10/2026

III. Provider practice location address

9221 S REDWOOD RD BLDG 3
WEST JORDAN UT
84088-5802
US

IV. Provider business mailing address

9221 S REDWOOD RD BLDG 3
WEST JORDAN UT
84088-5802
US

V. Phone/Fax

Practice location:
  • Phone: 801-814-4046
  • Fax:
Mailing address:
  • Phone: 801-814-4046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: