Healthcare Provider Details

I. General information

NPI: 1568366102
Provider Name (Legal Business Name): LIAM WALKER LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1489 S BROADWAY UNIT D
DENVER CO
80210-2206
US

IV. Provider business mailing address

1489 S BROADWAY UNIT D
DENVER CO
80210-2206
US

V. Phone/Fax

Practice location:
  • Phone: 720-515-9376
  • Fax:
Mailing address:
  • Phone: 720-515-9376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0027517
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: