Provider Demographics
NPI:1629803218
Name:UINTAH MANUAL THERAPY
Entity type:Organization
Organization Name:UINTAH MANUAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:801-702-3344
Mailing Address - Street 1:14201 S MOLASSES MILL DR
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7581
Mailing Address - Country:US
Mailing Address - Phone:801-702-3344
Mailing Address - Fax:
Practice Address - Street 1:880 E 9400 S STE 112
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-4134
Practice Address - Country:US
Practice Address - Phone:801-702-3344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty