# THERAPEUTIC MASSAGE & BODYWORK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407100639
- **Authorized official:** TIFFANY C JACKSON LMT (OWNER)
- **Authorized official phone:** (801) 687-3957

## Contact information

- **Practice address:** 904 S MAIN ST, PLEASANT GROVE, UT 84062-3560
- **Practice address phone:** (801) 687-3957
- **Mailing address:** 904 S MAIN ST, PLEASANT GROVE, UT 84062-3560
- **Mailing address phone:** (801) 687-3957

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 5370898-1202 | UT | Yes |
| 225700000X | Massage Therapist | 6077621-4701 | UT | — |
| 225700000X | Massage Therapist | 8407908-4701 | UT | — |

## Other

- **Enumeration date:** 11/09/2012
- **Last updated:** 12/07/2023