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General NPI Number Information
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NPI Number | 1679351779
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Entity Type | Individual
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Provider Name | MICHAELIA RAE MANZINI
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Gender | Female
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 168 N 100 E
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City | ST GEORGE
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State | UT
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Zip | 84770-2893
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Country | US
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Telephone | 775-316-0382
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Fax |
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Provider Business Mailing Address
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Address Line | 3476 S 5175 W
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City | CEDAR CITY
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State | UT
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Zip | 84720-6898
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Country | US
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Telephone | 775-316-0382
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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 | 14232820-4701
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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 | 8325
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License Number State | NV
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