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General NPI Number Information
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NPI Number | 1073396669
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Entity Type | Individual
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Provider Name | MICHAEL ANDREW FRAZIER LMT
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Gender | Male
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 3234 S WADSWORTH BLVD UNIT A
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City | LAKEWOOD
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State | CO
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Zip | 80227-5004
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Country | US
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Telephone | 303-955-4882
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Fax |
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Provider Business Mailing Address
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Address Line | 4587 HOLLAND ST
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City | WHEAT RIDGE
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State | CO
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Zip | 80033-3034
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Country | US
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Telephone | 720-218-2119
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0022720
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License Number State | CO
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