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General NPI Number Information
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NPI Number | 1053289967
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Entity Type | Organization
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Legal Business Name | LAVENDER MASSAGE LLC
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 4955 W 72ND AVE UNIT H
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City | WESTMINSTER
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State | CO
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Zip | 80030-5146
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Country | US
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Telephone | 720-970-1688
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Fax |
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Provider Business Mailing Address
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Address Line | 4955 W 72ND AVE UNIT H
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City | WESTMINSTER
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State | CO
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Zip | 80030-5146
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Country | US
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Telephone | 720-970-1688
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | YONGYAN CHEN
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Credential |
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Telephone | 729-970-1688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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