MEDICARE: EILEEN SUSAN DAVIS C.M.T.

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

General Provider Information

NPI Number	:	1467629691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN SUSAN DAVIS C.M.T.

Provider Business Mailing Address
First Line	:	3222 C RD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81503-9414
Country	:	US
Telephone Number	:	970-255-1559
Fax Number	:

Provider Business Practice Location Address
First Line	:	2505 FORESIGHT CIR
Second Line	:	UNIT C-2
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1081
Country	:	US
Telephone Number	:	970-255-1559
Fax Number	:

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

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	06/14/2026

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