MEDICARE: LORIN DANAE WINTERBERG LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT.0024952	CO

General Provider Information

NPI Number	:	1144020256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORIN DANAE WINTERBERG LMT

Provider Business Mailing Address
First Line	:	9418 ELMHURST DR
Second Line	:
City	:	FOUNTAIN
State	:	CO
Zip	:	80817-3165
Country	:	US
Telephone Number	:	808-990-0716
Fax Number	:

Provider Business Practice Location Address
First Line	:	2860 S CIRCLE DR STE 250
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4132
Country	:	US
Telephone Number	:	719-900-3009
Fax Number	:	719-931-1351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2025
Last Update Date	:	03/17/2025

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