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General NPI Number Information
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NPI Number | 1124734629
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Entity Type | Individual
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Provider Name | EMMA LAREE MCHENRY LMT
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Gender | Female
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Dates
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Enumeration Date | 01/27/2023
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 2130 MOUNTAIN VIEW AVE STE 205
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City | LONGMONT
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State | CO
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Zip | 80501-3177
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Country | US
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Telephone | 303-835-7882
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Fax |
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Provider Business Mailing Address
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Address Line | 972 MARTIN RD
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City | LONGMONT
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State | CO
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Zip | 80504-1221
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Country | US
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Telephone | 720-232-8853
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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 | 0025457
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License Number State | CO
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