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General NPI Number Information
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NPI Number | 1689899023
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Entity Type | Organization
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Legal Business Name | FRONT RANGE THERAPEUTIC MASSAGE CENTER INC
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9140 W 100TH AVE A6
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City | WESTMINSTER
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State | CO
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Zip | 80021
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Country | US
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Telephone | 720-320-9008
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Fax | 303-423-3136
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Provider Business Mailing Address
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Address Line | PO BOX 719
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City | MORRISON
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State | CO
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Zip | 80465-0719
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Country | US
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Telephone | 720-320-9008
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Fax | 303-423-3136
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUSAN WOODS
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Credential | CERTIFIED NEUROMUSCU
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Telephone | 720-320-9008
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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 | 2086601
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License Number State | CO
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