Individual
JANELLE MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, MMP, CCST
Contact information
Practice address
720 E NEW ENGLAND DR, SANDY, UT 84094-3590
(701) 340-1318
Mailing address
396 E WOODLAKE DR APT 83, SALT LAKE CITY, UT 84107-1637
(701) 340-1318
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9512691-4701
UT
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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