Healthcare Provider Details

I. General information

NPI: 1740420876
Provider Name (Legal Business Name): DEBORAH JANE HATCH RMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3880 N GRANT AVE STE 100
LOVELAND CO
80538-8433
US

IV. Provider business mailing address

2641 FARISITA DR
LOVELAND CO
80538-3405
US

V. Phone/Fax

Practice location:
  • Phone: 970-556-9277
  • Fax:
Mailing address:
  • Phone: 970-556-9277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number718062
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2558
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: