Organization
THERAPEUTIC MASSAGE & BODYWORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY C JACKSON LMT (OWNER)
(801) 687-3957
Entity
Organization
Contact information
Practice address
904 S MAIN ST, PLEASANT GROVE, UT 84062-3560
(801) 687-3957
Mailing address
904 S MAIN ST, PLEASANT GROVE, UT 84062-3560
(801) 687-3957
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5370898-1202
UT
225700000X
Massage Therapist
6077621-4701
UT
225700000X
Massage Therapist
8407908-4701
UT
Other
Enumeration date
11/09/2012
Last updated
12/07/2023
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