Healthcare Provider Details

I. General information

NPI: 1750583472
Provider Name (Legal Business Name): GARY FRANK REMES LMT.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 30TH ST 220A
BOULDER CO
80301-1088
US

IV. Provider business mailing address

4417 SAN MARCO DR.
LONGMONT CO
96741-1286
US

V. Phone/Fax

Practice location:
  • Phone: 720-505-1541
  • Fax:
Mailing address:
  • Phone: 720-505-1541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: