MEDICARE: ELIZABETH BOLTON BS, MS, 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	172M00000X	Mechanotherapist	MT.0027583	CO
2	225700000X	Massage Therapist	MT.0027583	CO

General Provider Information

NPI Number	:	1669320891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH BOLTON BS, MS, LMT

Provider Business Mailing Address
First Line	:	7495 LOWELL BLVD APT 22
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80030-4853
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 SPRUCE ST STE 202
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80302-5395
Country	:	US
Telephone Number	:	414-507-3129
Fax Number	:

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

Provider Enumeration Date	:	03/21/2026
Last Update Date	:	03/21/2026

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