Organization
THERAPUTIC SPA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA LARSON LMT (MANAGER)
(801) 447-8680
Entity
Organization
Contact information
Practice address
630 SHEPARD LN STE 102, FARMINGTON, UT 84025-3934
(801) 447-8680
(801) 447-4211
Mailing address
630 SHEPARD LN STE 102, FARMINGTON, UT 84025-3934
(801) 447-8680
(801) 447-4211
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
UT
Other
Enumeration date
07/22/2009
Last updated
07/22/2009
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