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General NPI Number Information
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NPI Number | 1144037235
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Entity Type | Organization
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Legal Business Name | BLISS BODYWORK
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 1055 17TH AVE STE 104
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City | LONGMONT
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State | CO
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Zip | 80501-2647
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Country | US
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Telephone | 720-713-4383
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Fax |
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Provider Business Mailing Address
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Address Line | 1055 17TH AVE STE 104
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City | LONGMONT
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State | CO
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Zip | 80501-2647
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MELISSA WETZEL
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Credential |
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Telephone | 720-713-4383
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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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