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General NPI Number Information
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NPI Number | 1649927823
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Entity Type | Individual
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Provider Name | VICTORIA GRACE BURRIS
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Gender | Female
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Dates
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Enumeration Date | 03/07/2022
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 10488 W CENTENNIAL RD
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City | LITTLETON
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State | CO
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Zip | 80127-4293
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Country | US
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Telephone | 720-220-1687
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Fax |
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Provider Business Mailing Address
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Address Line | 8520 S OAK CIR APT 1306
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City | LITTLETON
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State | CO
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Zip | 80127-5087
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Country | US
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Telephone | 312-402-4445
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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 | 23931
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License Number State | CO
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