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General NPI Number Information
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NPI Number | 1497195804
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Entity Type | Organization
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Legal Business Name | SMART MOVE MASSAGE THERAPY LLC
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Dates
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Enumeration Date | 06/29/2013
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Last Update Date | 06/29/2013
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Provider Practice Location Address
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Address Line | 109 W OLIVE ST
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City | FORT COLLINS
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State | CO
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Zip | 80524-2831
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Country | US
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Telephone | 970-231-1262
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Fax |
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Provider Business Mailing Address
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Address Line | 801 E DRAKE RD APT 72
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City | FORT COLLINS
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State | CO
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Zip | 80525-1870
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Country | US
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Telephone | 970-231-1262
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHERRI L SMITH
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Credential | RMT
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Telephone | 970-231-1262
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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-0014974
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License Number State | CO
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