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General NPI Number Information
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NPI Number | 1629910781
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Entity Type | Individual
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Provider Name | ALEXANDER ZIC LMT
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Gender | Male
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Dates
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Enumeration Date | 04/08/2026
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 5151 WARD RD UNIT 1
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City | WHEAT RIDGE
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State | CO
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Zip | 80033-1923
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Country | US
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Telephone | 303-946-9867
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Fax |
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Provider Business Mailing Address
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Address Line | 8675 LAMAR DR
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City | ARVADA
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State | CO
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Zip | 80003-1360
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Country | US
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Telephone | 303-946-9867
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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.0028200
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License Number State | CO
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