=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225539935
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALING SOLUTIONS INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2018
-----------------------------------------------------
Last Update Date | 02/27/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 362 S. MCCASLIN BLVD.
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-696-0124
-----------------------------------------------------
Fax | 303-664-1697
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5001 SPYGLASS DRIVE
-----------------------------------------------------
City | BROOMFIELD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80023
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-696-0124
-----------------------------------------------------
Fax | 303-664-1697
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. SUZETTE SKIDMORE
-----------------------------------------------------
Credential | LMT
-----------------------------------------------------
Telephone | 970-379-6187
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MT.0004404
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------