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General NPI Number Information
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NPI Number | 1114169067
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Entity Type | Individual
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Provider Name | AMBER LYNN STARK MASSAGE THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 03/24/2009
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Provider Practice Location Address
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Address Line | 8357 N RAMPART RANGE RD STE 205
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City | LITTLETON
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State | CO
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Zip | 80125-9365
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Country | US
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Telephone | 303-932-0081
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Fax | 303-932-1363
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Provider Business Mailing Address
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Address Line | 9063 W FLOYD AVE
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City | LAKEWOOD
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State | CO
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Zip | 80227-4682
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Country | US
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Telephone | 732-757-2582
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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 | 507
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License Number State | CO
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