Provider Demographics
NPI:1780895532
Name:ROCKY MOUNTAIN THERAPEUTIC MASSAGE
Entity type:Organization
Organization Name:ROCKY MOUNTAIN THERAPEUTIC MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BETTERIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-529-3314
Mailing Address - Street 1:1025 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-4857
Mailing Address - Country:US
Mailing Address - Phone:801-529-3314
Mailing Address - Fax:801-544-0063
Practice Address - Street 1:1025 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-4857
Practice Address - Country:US
Practice Address - Phone:801-529-3314
Practice Address - Fax:801-544-0063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty