MEDICARE: KALEY DIANE BARR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	14210575-4701	UT

General Provider Information

NPI Number	:	1114810561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALEY DIANE BARR

Provider Business Mailing Address
First Line	:	234 1/2 N SPENCER CT
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-2514
Country	:	US
Telephone Number	:	801-247-8856
Fax Number	:

Provider Business Practice Location Address
First Line	:	921 E EXECUTIVE PARK DR STE 921C
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84117-7262
Country	:	US
Telephone Number	:	385-831-1204
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	06/02/2025

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Directions to “ KALEY DIANE BARR ” Practice Location

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