| Original Therapy Llc | |
|
455 E 200 S Ste 110 Salt Lake City UT 84111-2156 | |
| (435) 994-9259 | |
| Not Available |
| Full Name | Original Therapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 455 E 200 S Ste 110, Salt Lake City, Utah |
| Authorized Official Name and Position | Tonya Lundahl (OWNER/DIRECTOR) |
| Authorized Official Contact | 4359949259 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Original Therapy Llc 1067 E Wood Ave Salt Lake City UT 84105-2411 Ph: () - | Original Therapy Llc 455 E 200 S Ste 110 Salt Lake City UT 84111-2156 Ph: (435) 994-9259 |
| NPI Number | 1083430011 |
|---|---|
| Provider Enumeration Date | 11/25/2024 |
| Last Update Date | 11/25/2024 |
| Certification Date | 11/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083430011 | NPI | - | NPPES |
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