Healthcare Provider Details

I. General information

NPI: 1477284511
Provider Name (Legal Business Name): CHRISTINA HEGSTROM ONSTOT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2022
Last Update Date: 06/20/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9370 S COLORADO BLVD
HIGHLANDS RANCH CO
80126-5205
US

IV. Provider business mailing address

6493 S DATURA ST
LITTLETON CO
80120-3218
US

V. Phone/Fax

Practice location:
  • Phone: 303-471-9355
  • Fax:
Mailing address:
  • Phone: 303-495-8333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number9574
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: