Individual
SENATOR ELLIOT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3435 E PONY EXPRESS PKWY STE 120, EAGLE MOUNTAIN, UT 84005-5520
(801) 996-7911
Mailing address
3435 E PONY EXPRESS PKWY STE 120, EAGLE MOUNTAIN, UT 84005-5520
(801) 996-7911
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8525090-4701
UT
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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