Healthcare Provider Details

I. General information

NPI: 1295576957
Provider Name (Legal Business Name): RISHA PAYNE LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 N 2000 W
WEST POINT UT
84015-8562
US

IV. Provider business mailing address

1298 N 100 W
LAYTON UT
84041-5045
US

V. Phone/Fax

Practice location:
  • Phone: 801-835-8040
  • Fax:
Mailing address:
  • Phone: 801-835-8040
  • 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:
Title or Position:
Credential:
Phone: