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General NPI Number Information
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NPI Number | 1710837604
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Entity Type | Organization
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Legal Business Name | INNATE WELLNESS LLC
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 216 MAIN ST STE 232
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City | EDWARDS
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State | CO
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Zip | 81632-8128
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Country | US
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Telephone | 970-331-1369
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2054
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City | EAGLE
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State | CO
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Zip | 81631-2054
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Country | US
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Telephone | 970-331-1369
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JOBY SIMPSON
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Credential | LMT
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Telephone | 970-331-1369
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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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