Healthcare Provider Details

I. General information

NPI: 1528583796
Provider Name (Legal Business Name): CAROLYN MEASE VRANY CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N 9TH ST STE 42
GRAND JUNCTION CO
81501-3154
US

IV. Provider business mailing address

365 29 RD
GRAND JUNCTION CO
81504-4601
US

V. Phone/Fax

Practice location:
  • Phone: 970-245-6408
  • Fax:
Mailing address:
  • Phone: 970-245-6408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT0001359
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: