NPI 1003049586

Anneliese Wilson

Practitioner Massage Therapist Provo, UT

Practice location

Address: 238 N University Ave APT 16, Provo, UT 84601-2821
Phone: (801) 373-3484
Mailing address: 710 W 800 N, Provo, UT 84601-1518

Registered specialties (2)

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 6149567-4701 (UT)

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Specialist

Other Service Providers Taxonomy 174400000X Licence 10378 (HI)

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Registry record

NPI: 1003049586
Entity type: Individual
Sex (as registered): Female
NPI issued: 31 Aug 2009
Record last updated: 22 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.