Individual
THEODOSIA BLAINE HENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1811 E WILLOW OAK CIR, SALT LAKE CITY, UT 84121-2196
(435) 659-9049
Mailing address
1811 E WILLOW OAK CIR, SALT LAKE CITY, UT 84121-2196
(435) 659-9049
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12275691-4701
UT
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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