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General NPI Number Information
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NPI Number | 1689223984
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Entity Type | Individual
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Provider Name | ELSIE VAUGHN HARGIS LMT
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Gender | Female
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 7630 CHANCELLOR DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7143
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Country | US
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Telephone | 719-231-5280
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Fax |
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Provider Business Mailing Address
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Address Line | 7630 CHANCELLOR DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7143
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Country | US
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Telephone | 719-231-5280
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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 | 60964071
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT.0022889
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License Number State | CO
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