MEDICARE: GALE ANNE RICHARDSON 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	MT.0007593	CO

General Provider Information

NPI Number	:	1700502820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GALE ANNE RICHARDSON LMT

Provider Business Mailing Address
First Line	:	155 PRINTERS PKWY STE 110
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-6101
Country	:	US
Telephone Number	:	719-650-9094
Fax Number	:	719-471-9053

Provider Business Practice Location Address
First Line	:	155 PRINTERS PKWY STE 110
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-6101
Country	:	US
Telephone Number	:	719-650-9094
Fax Number	:	719-471-9053

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

Provider Enumeration Date	:	10/19/2022
Last Update Date	:	10/19/2022

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