Healthcare Provider Details

I. General information

NPI: 1790923803
Provider Name (Legal Business Name): MONIQUE CHRISTINE ORTEGA CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1574 YORK ST
DENVER CO
80206-1400
US

IV. Provider business mailing address

4345 COLUMBINE STREET
DENVER CO
80216-3926
US

V. Phone/Fax

Practice location:
  • Phone: 303-308-3702
  • Fax:
Mailing address:
  • Phone: 303-308-3702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number1031235
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number1031235
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: