MEDICARE: AU COURANT MASSAGE INC.

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-7386	CO

General Provider Information

NPI Number	:	1447524517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AU COURANT MASSAGE INC.

Provider Business Mailing Address
First Line	:	790 CLERMONT ST
Second Line	:	7
City	:	DENVER
State	:	CO
Zip	:	80220-5000
Country	:	US
Telephone Number	:	720-309-7904
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 SANTA FE DR
Second Line	:	19
City	:	DENVER
State	:	CO
Zip	:	80204-3975
Country	:	US
Telephone Number	:	720-309-7904
Fax Number	:

Authorized Official
Title or Position	:	MASSAGE THERAPIST
Name	:	MARCHELLA D SCOTT
Credential	:	LMT
Telephone Number	:	720-309-7904

Provider Enumeration Date	:	03/06/2012
Last Update Date	:	03/06/2012

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