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General NPI Number Information
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NPI Number | 1518324698
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Entity Type | Individual
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Provider Name | VICTORIA SERNA L.M.T
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Gender | Female
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 820 CASTLE VALLEY BLVD STE 210
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City | NEW CASTLE
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State | CO
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Zip | 81647-9453
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Country | US
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Telephone | 970-989-8702
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Fax | 970-984-3198
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Provider Business Mailing Address
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Address Line | 5033 COUNTY ROAD 335 TRLR 26
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City | NEW CASTLE
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State | CO
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Zip | 81647-9663
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Country | US
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Telephone | 970-989-8702
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Fax | 970-984-3198
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number | MT.008324
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License Number State | CO
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