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General NPI Number Information
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NPI Number | 1407679319
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Entity Type | Individual
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Provider Name | LORENA DEBRA MARTINEZ LMT
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Gender | Female
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 2460 W 26TH AVE STE 40C
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City | DENVER
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State | CO
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Zip | 80211-5341
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Country | US
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Telephone | 720-401-5728
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Fax |
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Provider Business Mailing Address
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Address Line | 573 VAN GORDON ST APT 2-116
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City | LAKEWOOD
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State | CO
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Zip | 80228-1216
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Country | US
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Telephone | 505-488-1254
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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.0026408
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License Number State | CO
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