Landon Otto Jarvies, LMT
Individual provider Active NPI Massage Therapist · Mapleton, UT
NPI 1578179768 · NPPES record last updated Sep 22, 2020
Key facts
- NPI
- 1578179768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 154418 (UT)
- Practice address
- 2254 W 325 S
Mapleton, UT 84664-4312 - Phone
- (385) 216-2382
- NPI assigned
- Sep 22, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 154418 | UT | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist |
225700000X | 154418 | UT | Yes |
Addresses
Primary practice location
2254 W 325 S
Mapleton, UT 84664-4312
Mailing address
2254 W 325 S
Mapleton, UT 84664-4312
Phone (385) 216-2382
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | rebalanceofficial@gmail.com | Direct |
Other providers in Mapleton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.