Provider Demographics
NPI:1881563138
Name:LONE PEAK THERAPEUTIC MASSAGE
Entity type:Organization
Organization Name:LONE PEAK THERAPEUTIC MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-380-9051
Mailing Address - Street 1:4135 E SUN CREST DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-5269
Mailing Address - Country:US
Mailing Address - Phone:801-380-9051
Mailing Address - Fax:
Practice Address - Street 1:789 E BAMBERGER DR STE C
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2183
Practice Address - Country:US
Practice Address - Phone:801-692-3216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty