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General NPI Number Information
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NPI Number | 1700183316
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Entity Type | Individual
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Provider Name | SHELLY BARTLETT
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Gender | Female
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Dates
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Enumeration Date | 02/16/2011
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 1823 65TH AVE # 3
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City | GREELEY
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State | CO
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Zip | 80634-7943
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Country | US
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Telephone | 970-352-7676
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Fax |
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Provider Business Mailing Address
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Address Line | 7601 COUNTY ROAD 54
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City | JOHNSTOWN
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State | CO
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Zip | 80534-9610
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Country | US
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Telephone | 970-590-5058
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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 | 3070
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License Number State | CO
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