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General NPI Number Information
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NPI Number | 1356195465
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Entity Type | Organization
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Legal Business Name | AMMON HARDIN MASSAGE THERAPY
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Dates
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Enumeration Date | 04/15/2024
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Last Update Date | 04/20/2025
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Provider Practice Location Address
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Address Line | 4434 S HIGHLAND DR
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City | MILLCREEK
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State | UT
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Zip | 84124-3533
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Country | US
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Telephone | 385-831-1204
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Fax | 877-283-3682
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Provider Business Mailing Address
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Address Line | 6807 S NORMANDY PL
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City | MIDVALE
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State | UT
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Zip | 84047-1435
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Country | US
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Telephone | 385-831-1204
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Fax | 877-283-3682
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Authorized Official
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Title or Position | OWNER
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Name | AMMON HARDIN
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Credential | LMT
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Telephone | 385-831-1204
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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 |
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License Number State |
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