Healthcare Provider Details

I. General information

NPI: 1821932013
Provider Name (Legal Business Name): WHITLEY LUOMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 COFFMAN ST STE B
LONGMONT CO
80501-8303
US

IV. Provider business mailing address

229 SILVERBELL DR
JOHNSTOWN CO
80534-9188
US

V. Phone/Fax

Practice location:
  • Phone: 303-652-3533
  • Fax:
Mailing address:
  • Phone: 970-324-5781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0026628
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: