Provider Demographics
NPI:1275374589
Name:LEHMAN, TRAVIS M (LMT)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:M
Last Name:LEHMAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 E 2450 N
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-5729
Mailing Address - Country:US
Mailing Address - Phone:541-218-8452
Mailing Address - Fax:
Practice Address - Street 1:1401 N 1075 W STE 220
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2745
Practice Address - Country:US
Practice Address - Phone:801-897-8711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13899494-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist