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General NPI Number Information
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NPI Number | 1417878232
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Entity Type | Organization
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Legal Business Name | YOUR NEXT STEP WELLNESS, LLC
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Dates
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Enumeration Date | 07/25/2026
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Last Update Date | 07/25/2026
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Provider Practice Location Address
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Address Line | 1010 DEPOT HILL RD STE 100
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City | BROOMFIELD
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State | CO
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Zip | 80020-6738
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Country | US
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Telephone | 720-819-6366
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Fax | 888-649-9945
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Provider Business Mailing Address
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Address Line | 1010 DEPOT HILL RD STE 100
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City | BROOMFIELD
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State | CO
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Zip | 80020-6738
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Country | US
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Telephone | 720-819-6366
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Fax | 888-649-9945
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MR. SHANE E. DITLOW
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Credential | MT
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Telephone | 720-819-6366
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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 |
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License Number State |
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