| NPI | 1326446071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT KINGSBURY Owner 970-343-0822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CO 0017103) |
| 225700000X Massage Therapist (Licence: CO 0015865) | |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2021-08-02 |