Provider Demographics
NPI:1245941905
Name:GARRISON, JOSHUA D (LMT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:D
Last Name:GARRISON
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1371 N 1075 W STE 3
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2877
Mailing Address - Country:US
Mailing Address - Phone:801-669-9378
Mailing Address - Fax:
Practice Address - Street 1:1371 N 1075 W STE 3
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2877
Practice Address - Country:US
Practice Address - Phone:801-669-9378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist