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General NPI Number Information
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NPI Number | 1356695472
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Entity Type | Organization
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Legal Business Name | ONE EARTH IMPORTS, INC
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Dates
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Enumeration Date | 10/29/2012
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Last Update Date | 10/29/2012
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Provider Practice Location Address
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Address Line | 1425 BRENTWOOD ST STE 16
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City | LAKEWOOD
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State | CO
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Zip | 80214-4064
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Country | US
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Telephone | 303-981-0790
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 140687
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City | EDGEWATER
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State | CO
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Zip | 80214-0687
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Country | US
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Telephone | 303-981-0790
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANET MCCANN
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Credential |
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Telephone | 303-981-0790
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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 | MT0011906
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License Number State | CO
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