Healthcare Provider Details

I. General information

NPI: 1447249271
Provider Name (Legal Business Name): YATAKA D MAGEE CMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9195 GRANT ST SUITE 100
THORNTON CO
80229-4385
US

IV. Provider business mailing address

720 S COLORADO BLVD SUITE 200-A, DEPT 914
GLENDALE CO
80246-1912
US

V. Phone/Fax

Practice location:
  • Phone: 303-451-7700
  • Fax: 303-252-9474
Mailing address:
  • Phone: 303-584-8000
  • Fax: 303-584-8141

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: