MEDICARE: ROBBYE LYDICK 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	002526	CO

General Provider Information

NPI Number	:	1487162210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBBYE LYDICK LMT

Provider Business Mailing Address
First Line	:	5710 S FOX ST
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80120-2310
Country	:	US
Telephone Number	:	720-207-4054
Fax Number	:

Provider Business Practice Location Address
First Line	:	899 N LOGAN ST STE 204
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-3154
Country	:	US
Telephone Number	:	720-295-8053
Fax Number	:

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

Provider Enumeration Date	:	01/15/2018
Last Update Date	:	01/15/2018

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Directions to “ ROBBYE LYDICK LMT” Practice Location

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