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General NPI Number Information
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NPI Number | 1225644305
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Entity Type | Individual
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Provider Name | STACEY COLSON LMT
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Gender | Female
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Dates
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Enumeration Date | 09/23/2020
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 7261 S BROADWAY STE 104
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City | LITTLETON
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State | CO
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Zip | 80122-8003
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Country | US
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Telephone | 720-648-6262
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 S BANNOCK ST
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City | ENGLEWOOD
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State | CO
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Zip | 80110-1518
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Country | US
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Telephone | 720-648-6262
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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 | 0013617
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License Number State | CO
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