Healthcare Provider Details

I. General information

NPI: 1871408187
Provider Name (Legal Business Name): MS. HOLLY JOY STUTZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 MOUNTAIN VIEW AVE
LONGMONT CO
80501-3212
US

IV. Provider business mailing address

1840 MOUNTAIN VIEW AVE
LONGMONT CO
80501-3212
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0024442
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: