Individual
KYLEE HARVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
707 24TH ST STE A, OGDEN, UT 84401-2580
(801) 458-0203
Mailing address
1333 LORL LN APT 1, OGDEN, UT 84404-8027
(801) 458-0203
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10769047-4701
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107690474701
TRIWEST
UT
Enumeration date
11/01/2021
Last updated
11/01/2021
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