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NPI 1316484082

NPI 1316484082 : JUDITH KAPLER BISHOP LMT : MIDWAY, UT

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General NPI Number Information
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    NPI Number           |    1316484082
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    Entity Type          |    Individual 
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    Provider Name        |    JUDITH KAPLER BISHOP LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/19/2017
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    Last Update Date     |    01/19/2017
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Provider Practice Location Address
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    Address Line         |    850 MICHIE LN 
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    City                 |    MIDWAY
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    State                |    UT
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    Zip                  |    84049-6710
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    Country              |    US
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    Telephone            |    435-655-5410
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    850 MICHIE LN 
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    City                 |    MIDWAY
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    State                |    UT
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    Zip                  |    84049-6710
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    Country              |    US
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    Telephone            |    435-655-5410
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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       |    7765002-4701
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    License Number State |    UT
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Taxonomy #2
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    MT010626
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    License Number State |    GA
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