Lacy Mae Johnson, MASSAGE THERAPIST

NPI #1902574999 in South Ogden, Utah

Provider Information

NPI Number: 1902574999
Entity Type: Individual
Name: Lacy Mae Johnson, MASSAGE THERAPIST
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Credential: MASSAGE THERAPIST
Enumeration Date: Sep 2, 2021
Last Updated: Sep 2, 2021

Practice Location

Address: 1190 E 5425 S STE 210
City: South Ogden
State: Utah
ZIP Code: 84403-5194
Phone: (385) 400-9193

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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