=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184170656
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARLA AKERS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2016
-----------------------------------------------------
Last Update Date | 11/09/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1180 MAIN ST UNIT 7
-----------------------------------------------------
City | WINDSOR
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80550-4753
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-686-9117
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1434 CANAL DR
-----------------------------------------------------
City | WINDSOR
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80550-5811
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-201-7852
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MT.0007963
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------