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General NPI Number Information
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NPI Number | 1932617495
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Entity Type | Organization
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Legal Business Name | ULTIMATE TOUCH MASSAGE LLC
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Dates
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Enumeration Date | 01/18/2018
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Last Update Date | 01/18/2018
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Provider Practice Location Address
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Address Line | 1893 E SKYLINE DR
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City | SOUTH OGDEN
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State | UT
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Zip | 84403-5218
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Country | US
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Telephone | 801-645-4195
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Fax |
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Provider Business Mailing Address
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Address Line | 4729 S 200 W
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City | OGDEN
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State | UT
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Zip | 84405-6109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DANIEL BADAL
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Credential |
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Telephone | 801-645-4195
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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 | 361722-4701
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License Number State | UT
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