NPI 1063103141

Senator Elliot Wilson

Practitioner Massage Therapist Eagle Mountain, UT

Practice location

Address: 3435 E Pony Express Pkwy STE 120, Eagle Mountain, UT 84005-5520
Phone: (801) 996-7911

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 8525090-4701 (UT)

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Registry record

NPI: 1063103141
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 May 2023
Record last updated: 18 May 2023

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.