Individual
CAROL LYNN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4309 E GOLDEN GRV, EAGLE MOUNTAIN, UT 84005-5421
(503) 586-8462
Mailing address
4309 E GOLDEN GRV, EAGLE MOUNTAIN, UT 84005-5421
(503) 586-8462
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14185493-4701
UT
Other
Enumeration date
04/23/2026
Last updated
04/23/2026
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