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1427756519
TEAGAN CLARK BALLINLEE DRAKE
LONGMONT, CO
NPI
1427756519
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
(Licence: CO 0025597)
Enumeration Date
2023-02-20
Last Update Date
2023-02-20
Business Address
Mr. TEAGAN CLARK BALLINLEE DRAKE LMT
2130 MOUNTAIN VIEW AVE STE 205
LONGMONT, CO 80501-3177
Phone number: 303-835-7882
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Mailing Address
Mr. TEAGAN CLARK BALLINLEE DRAKE LMT
1065 REDBUD CIR
LONGMONT, CO 80503-7351
Phone number: 469-426-5542
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