Healthcare Provider Details

I. General information

NPI: 1093307506
Provider Name (Legal Business Name): BONNIE J SCARLETT LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BONNIE J BRITTON LMT

II. Dates (important events)

Enumeration Date: 02/05/2021
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 CHAPEL HILLS DR STE 200
COLORADO SPRINGS CO
80920-1056
US

IV. Provider business mailing address

5259 TERRITORIAL ST
PARKER CO
80134-2744
US

V. Phone/Fax

Practice location:
  • Phone: 719-201-8857
  • Fax: 719-735-1156
Mailing address:
  • Phone: 719-201-8857
  • Fax: 719-735-1156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT0007356
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License NumberMT0007356
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: