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1851887590
DANIEL BANTA ETHINGTON
WEST JORDAN, UT
NPI
1851887590
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: UT 108638114701)
Enumeration Date
2018-07-05
Last Update Date
2018-07-05
Business Address
DANIEL BANTA ETHINGTON LMT
9317 S TANYA AVE
WEST JORDAN, UT 84088-8529
Phone number: 801-244-3384
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Mailing Address
DANIEL BANTA ETHINGTON LMT
9317 S TANYA AVE
WEST JORDAN, UT 84088-8529
Phone number: 801-244-3384
Copy
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