Healthcare Provider Details

I. General information

NPI: 1518152248
Provider Name (Legal Business Name): DENISE ELLEN GEDDES CMT/CLT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 09/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22327 S HWY 550
RIDGWAY CO
81432
US

IV. Provider business mailing address

PO BOX 1376
OURAY CO
81427-1376
US

V. Phone/Fax

Practice location:
  • Phone: 970-261-2308
  • Fax: 970-626-5417
Mailing address:
  • Phone: 970-261-2308
  • Fax: 970-626-5417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: