Healthcare Provider Details

I. General information

NPI: 1790014140
Provider Name (Legal Business Name): MARVIN R. GREINER RMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2009
Last Update Date: 12/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8725 WADSWORTH BLVD UNIT A
ARVADA CO
80003-0928
US

IV. Provider business mailing address

4435 W 50TH AVE
DENVER CO
80212-2920
US

V. Phone/Fax

Practice location:
  • Phone: 303-425-7298
  • Fax: 303-940-8330
Mailing address:
  • Phone: 303-877-1735
  • Fax: 303-940-8330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number540
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: