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General NPI Number Information
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NPI Number | 1679149843
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Entity Type | Organization
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Legal Business Name | MILE HIGH MEDICAL MASSAGE, LLC
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Dates
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Enumeration Date | 05/28/2021
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Last Update Date | 05/28/2021
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Provider Practice Location Address
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Address Line | 1390 S POTOMAC ST STE 128
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City | AURORA
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State | CO
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Zip | 80012-4529
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Country | US
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Telephone | 303-306-2408
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Fax | 720-439-9527
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Provider Business Mailing Address
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Address Line | 1390 S POTOMAC ST STE 128
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City | AURORA
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State | CO
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Zip | 80012-4529
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Country | US
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Telephone | 303-306-2408
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Fax | 720-439-9527
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Authorized Official
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Title or Position | CEO
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Name | MARIA HOWARD
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Credential |
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Telephone | 303-306-2452
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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 |
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License Number State |
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