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General NPI Number Information
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NPI Number | 1518739911
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Entity Type | Organization
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Legal Business Name | PREMIER MASSAGE CARE & SERVICES LLC
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Dates
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Enumeration Date | 10/27/2023
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 5525 ERINDALE DR STE 120
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-6960
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Country | US
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Telephone | 405-921-1308
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Fax | 719-224-9840
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Provider Business Mailing Address
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Address Line | 5525 ERINDALE DR STE 120
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-6960
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Country | US
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Telephone | 719-362-6479
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Fax | 719-224-9840
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Authorized Official
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Title or Position | OWNER/LMT
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Name | MARRA THOMPSON
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Credential | LMT
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Telephone | 405-921-1308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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