Healthcare Provider Details

I. General information

NPI: 1598988511
Provider Name (Legal Business Name): KORINA FELKERS MST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 E SIMPSON ST STE. 100
LAFAYETTE CO
80026-2297
US

IV. Provider business mailing address

103 E SIMPSON ST STE. 100
LAFAYETTE CO
80026-2297
US

V. Phone/Fax

Practice location:
  • Phone: 720-939-9080
  • Fax:
Mailing address:
  • Phone: 720-939-9080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: