Healthcare Provider Details

I. General information

NPI: 1083993885
Provider Name (Legal Business Name): RACHEL OQUINN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2011
Last Update Date: 08/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2107 TEMPLETON GAP RD SUITE D
COLORADO SPRINGS CO
80907-7100
US

IV. Provider business mailing address

2107 TEMPLETON GAP RD SUITE D
COLORADO SPRINGS CO
80907-7100
US

V. Phone/Fax

Practice location:
  • Phone: 719-358-8653
  • Fax: 719-358-8653
Mailing address:
  • Phone: 719-358-8653
  • Fax: 719-358-8653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number11408
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: