Individual
MONICA BIRTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2180 E 4500 S, SUITE 150-E, HOLLADAY, UT 84117-4434
(801) 673-0060
Mailing address
2558 E CUPECOY DR, SALT LAKE CITY, UT 84121-3243
(801) 673-0060
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8693718-4701
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
618605600
ACS (FECA)
UT
Enumeration date
03/12/2015
Last updated
05/23/2016
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