Provider Demographics
NPI:1083920847
Name:SAUL NEUMAN, LETA MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:LETA
Middle Name:MARIE
Last Name:SAUL NEUMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5329 RUSTIC DR
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-4452
Mailing Address - Country:US
Mailing Address - Phone:801-979-9018
Mailing Address - Fax:510-991-9018
Practice Address - Street 1:1331 S STATE ST
Practice Address - Street 2:SUITE 105A
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-5477
Practice Address - Country:US
Practice Address - Phone:801-979-9018
Practice Address - Fax:510-991-9018
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6626518-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist