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NPI Code Detail

MEDICARE: LISA COLLING LMT

MEDICARE:   LISA  COLLING  LMT
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
1225700000XMassage Therapist10495419-4701UT
2225700000XMassage Therapist030073-01NY

General Provider Information

NPI Number : 1487360863
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA COLLING LMT
Provider Business Mailing Address
First Line : 515 S 700 E STE 2D
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-2858
Country : US
Telephone Number : 315-576-0413
Fax Number :
Provider Business Practice Location Address
First Line : 515 S 700 E STE 2D
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-2858
Country : US
Telephone Number : 315-576-0413
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2023
Last Update Date : 01/27/2023

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Directions to “ LISA COLLING LMT” Practice Location

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