MEDICARE: ASHLEY HARPER GRIFFIN 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	0018689	CO

General Provider Information

NPI Number	:	1598421810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY HARPER GRIFFIN LMT

Provider Business Mailing Address
First Line	:	1491 DENVER AVE UNIT 101
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-5228
Country	:	US
Telephone Number	:	970-663-2225
Fax Number	:	970-593-6748

Provider Business Practice Location Address
First Line	:	4038 S TIMBERLINE RD UNIT 120
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-6004
Country	:	US
Telephone Number	:	970-663-2225
Fax Number	:	970-593-6748

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

Provider Enumeration Date	:	11/10/2021
Last Update Date	:	11/10/2021

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