Organization
CANYON GATE MASSAGE THERAPY AND WELLNESS LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA BREITLING NELL LMT (PARTNER)
(801) 602-5091
Entity
Organization
Contact information
Practice address
1145 E 800 N, OREM, UT 84097-5401
(801) 613-0825
Mailing address
1145 E 800 N, OREM, UT 84097-5401
(801) 613-0825
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
30847244701
UT
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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