Healthcare Provider Details

I. General information

NPI: 1164619755
Provider Name (Legal Business Name): ROXANNA J WILLIAMSON L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 W 10TH ST STE 109
GREELEY CO
80634-5300
US

IV. Provider business mailing address

3011 W 10TH ST STE 109
GREELEY CO
80634-5300
US

V. Phone/Fax

Practice location:
  • Phone: 970-652-7425
  • Fax:
Mailing address:
  • Phone: 970-652-7425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMT.0018692
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberMT0018692
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: