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General NPI Number Information
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NPI Number | 1669334561
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Entity Type | Individual
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Provider Name | AUDREY TAYLOR
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Gender | Female
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Dates
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Enumeration Date | 11/29/2025
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Last Update Date | 11/29/2025
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Provider Practice Location Address
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Address Line | 9221 S REDWOOD RD STE B
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City | WEST JORDAN
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State | UT
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Zip | 84088-5803
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Country | US
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Telephone | 801-949-4449
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Fax |
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Provider Business Mailing Address
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Address Line | 11365 S BIG SKY DR
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City | SANDY
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State | UT
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Zip | 84070-7017
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Country | US
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Telephone | 260-602-6567
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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 | 13982676-4701
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License Number State | UT
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