Individual
LISA BREITLING NELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1452 E 820 N, OREM, UT 84097-5481
(801) 613-8025
Mailing address
787 W 150 N, OREM, UT 84057-4580
(801) 602-5091
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3084724-4701
UT
Other
Enumeration date
02/15/2018
Last updated
06/16/2018
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