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General NPI Number Information
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NPI Number | 1679877088
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Entity Type | Individual
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Provider Name | CYNTHIA MACDONALD HEDDEN LMT,CLT
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Gender | Female
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Dates
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Enumeration Date | 12/28/2010
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Last Update Date | 12/28/2010
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Provider Practice Location Address
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Address Line | 1120 W 3940 S
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City | HURRICANE
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State | UT
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Zip | 84737-2669
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Country | US
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Telephone | 435-632-5535
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Fax | 435-635-9390
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Provider Business Mailing Address
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Address Line | 1120 W 3940 S
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City | HURRICANE
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State | UT
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Zip | 84737-2669
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Country | US
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Telephone | 435-632-5535
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Fax | 435-635-9390
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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 | 5522078-4701
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License Number State | UT
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