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General NPI Number Information
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NPI Number | 1184469447
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Entity Type | Individual
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Provider Name | AUBRIANNA THOMSON
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Gender | Female
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Dates
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Enumeration Date | 06/28/2024
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 363 S 500 E STE 210
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-4002
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Country | US
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Telephone | 801-355-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 74 E RESACA DR UNIT B1
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City | SANDY
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State | UT
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Zip | 84070-2064
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Country | US
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Telephone | 801-259-3073
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 13901683-4701
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License Number State | UT
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