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NPI Code Detail

MEDICARE: DAILA LIERRA COSGROVE

MEDICARE: DAILA LIERRA COSGROVE
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
1225700000XMassage TherapistMT.0024824CO

General Provider Information

NPI Number : 1285448217
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAILA LIERRA COSGROVE
Provider Business Mailing Address
First Line : 697 1675 RD
Second Line :
City : DELTA
State : CO
Zip : 81416-3462
Country : US
Telephone Number : 970-985-1491
Fax Number :
Provider Business Practice Location Address
First Line : 697 1675 RD
Second Line :
City : DELTA
State : CO
Zip : 81416-3462
Country : US
Telephone Number : 970-985-1491
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2025
Last Update Date : 01/31/2025

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Directions to “ DAILA LIERRA COSGROVE ” Practice Location

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