Individual
BENJAMIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1153 E 3900 S, SALT LAKE CITY, UT 84124-1201
(801) 262-6331
Mailing address
1153 E 3900 S, SALT LAKE CITY, UT 84124-1201
(801) 262-6331
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9118209-4701
UT
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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