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General NPI Number Information
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NPI Number | 1336461615
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Entity Type | Organization
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Legal Business Name | HAPPY MANTAS WELLNESS TREE
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Dates
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Enumeration Date | 02/26/2010
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Last Update Date | 03/26/2010
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Provider Practice Location Address
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Address Line | 720 S COLORADO BLVD STE162A
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City | GLENDALE
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State | CO
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Zip | 80246-1904
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Country | US
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Telephone | 303-847-5519
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Fax |
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Provider Business Mailing Address
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Address Line | 1302 COLUMBINE ST 206
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City | DENVER
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State | CO
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Zip | 80206-2316
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Country | US
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Telephone | 303-847-5519
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NOELLE MANTAS
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Credential |
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Telephone | 303-847-5519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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