Healthcare Provider Details

I. General information

NPI: 1265362115
Provider Name (Legal Business Name): COURTNEY MARTIN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 S CIRCLE DR UNIT 250A
COLORADO SPRINGS CO
80906-4113
US

IV. Provider business mailing address

765 ROYAL CROWN LN
COLORADO SPRINGS CO
80906-5994
US

V. Phone/Fax

Practice location:
  • Phone: 719-900-3009
  • Fax:
Mailing address:
  • Phone: 513-292-5989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0027350
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: