LYDIA M. PROVOST

AURORA, CO
NPI1568772143
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225700000X Massage Therapist
(Licence: CO  9091, MT)
Enumeration Date2010-10-15
Last Update Date2010-10-15
Business Address
-- LYDIA M. PROVOST C.M.T.
2226 SOUTH FRASER STREET, UNIT 5
AURORA, CO 80014-4534
Phone number: 303-695-1609
Mailing Address
-- LYDIA M. PROVOST C.M.T.
1848 S. GENOA STREET
AURORA, CO 80017
Phone number: 303-564-7032
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