Healthcare Provider Details
I. General information
NPI: 1508785924
Provider Name (Legal Business Name): GRIP STRENGTH SPORTS THERAPY & MASSAGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3510 GALLEY RD STE 102
COLORADO SPRINGS CO
80909
US
IV. Provider business mailing address
3510 GALLEY RD STE 102
COLORADO SPRINGS CO
80909-4353
US
V. Phone/Fax
- Phone: 719-859-7111
- Fax:
- Phone: 719-859-7111
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEBORAH
JEAN
KERNES-NICHOLSON
Title or Position: OWNER
Credential: LMT
Phone: 719-859-7111