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General NPI Number Information
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NPI Number | 1255820064
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Entity Type | Individual
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Provider Name | ALIYA BOOZARI MT
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Gender | Female
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 07/09/2021
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Provider Practice Location Address
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Address Line | # 901 321 S. 1ST STREET
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City | MONTROSE
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State | CO
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Zip | 81401
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Country | US
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Telephone | 970-333-0968
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 901
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City | MONTROSE
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State | CO
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Zip | 81402-0901
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Country | US
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Telephone | 970-333-0968
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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 | MT.0018341
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.1668570
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License Number State | CO
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