Healthcare Provider Details

I. General information

NPI: 1083103535
Provider Name (Legal Business Name): BEYOND MASSAGE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 05/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S SPRING ST STE 203
ASPEN CO
81611-2806
US

IV. Provider business mailing address

300 S SPRING ST STE 203
ASPEN CO
81611-2806
US

V. Phone/Fax

Practice location:
  • Phone: 970-274-8717
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: ERICA BOULANGEE
Title or Position: OWNER
Credential: L.AC
Phone: 970-274-8717