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General NPI Number Information
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NPI Number | 1407613847
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Entity Type | Individual
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Provider Name | MICHELLE LYNN ALLISON LMT
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Gender | Female
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 1133 N MAIN ST STE 300
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City | LAYTON
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State | UT
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Zip | 84041-5339
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Country | US
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Telephone | 801-244-0606
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Fax |
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Provider Business Mailing Address
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Address Line | 6610 S 2200 E
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City | UINTAH
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State | UT
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Zip | 84405-9708
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Country | US
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Telephone | 801-244-0606
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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 | 13431521-4701
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License Number State | UT
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