Individual
MISS COURTNEY BETH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
363 N UNIVERSITY AVE STE 110, PROVO, UT 84601-8425
(801) 901-7330
Mailing address
363 N UNIVERSITY AVE STE 110, PROVO, UT 84601-8425
(801) 901-7330
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8043178-4701
UT
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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