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Organization

ASSOCIATION OF LYMPHATIC THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. GRETCHEN GIVONE L.M.T., C.D.T. (DIRECTOR)
(801) 990-1959
Entity
Organization

Contact information

Practice address
11075 S STATE STREET BLDG. #35, SANDY, UT 84070
(801) 990-1990
Mailing address
11075 S STATE STREET BLDG. #35, SANDY, UT 84070
(801) 990-1990

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
278061-2401
UT
225700000X
Massage Therapist
7617767-4701
UT

Other

Enumeration date
11/26/2012
Last updated
11/26/2012
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