Brandon Blacka, MHT

NPI #1992216105 in Spanish Fork, Utah

Provider Information

NPI Number: 1992216105
Entity Type: Individual
Name: Brandon Blacka, MHT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Credential: MHT
Enumeration Date: Oct 14, 2017
Last Updated: Oct 14, 2017

Practice Location

Address: 800 N 100 E
City: Spanish Fork
State: Utah
ZIP Code: 84660-5577
Phone: (801) 504-6125

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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