Individual
THOMAS NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10564791-4701
UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING
UT
Enumeration date
07/18/2018
Last updated
07/18/2018
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