Healthcare Provider Details

I. General information

NPI: 1285759951
Provider Name (Legal Business Name): MUSCULAR CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5650 GREENWOOD PLAZA BLVD STE 116
GREENWOOD VILLAGE CO
80111-2307
US

IV. Provider business mailing address

PO BOX 4054
GREENWOOD VILLAGE CO
80155-4054
US

V. Phone/Fax

Practice location:
  • Phone: 720-488-6495
  • Fax: 720-482-8296
Mailing address:
  • Phone: 720-488-6495
  • Fax: 720-482-8296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. ROGER HYATT
Title or Position: OWNER
Credential:
Phone: 720-488-6495