MEDICARE: CINDY ELIZABETH LEE 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
1	225700000X	Massage Therapist	8339862-4701	UT

General Provider Information

NPI Number	:	1720595275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY ELIZABETH LEE LMT

Provider Business Mailing Address
First Line	:	129 E COATSVILLE AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-1924
Country	:	US
Telephone Number	:	435-655-5265
Fax Number	:

Provider Business Practice Location Address
First Line	:	4427 S 2950 E
Second Line	:
City	:	SLC
State	:	UT
Zip	:	84124-3740
Country	:	US
Telephone Number	:	435-655-5265
Fax Number	:

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

Provider Enumeration Date	:	01/05/2018
Last Update Date	:	01/05/2018

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Directions to “ CINDY ELIZABETH LEE LMT” Practice Location

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