Healthcare Provider Details

I. General information

NPI: 1225957962
Provider Name (Legal Business Name): JESSICA VERBECK MT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9348 GRAND CORDERA PKWY STE 220
COLORADO SPRINGS CO
80924-7085
US

IV. Provider business mailing address

9348 GRAND CORDERA PKWY STE 220
COLORADO SPRINGS CO
80924-7085
US

V. Phone/Fax

Practice location:
  • Phone: 719-593-0300
  • Fax:
Mailing address:
  • Phone: 719-593-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0026045
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: