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General NPI Number Information
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NPI Number | 1750945127
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Entity Type | Individual
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Provider Name | TIMOTHY JAMES SANTNER LMT
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Gender | Male
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 04/30/2019
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Provider Practice Location Address
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Address Line | 2995 BASELINE RD STE 110
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City | BOULDER
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State | CO
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Zip | 80303-2318
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Country | US
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Telephone | 303-444-0192
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 S ROCK CREEK PKWY APT 16-203
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City | SUPERIOR
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State | CO
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Zip | 80027-4457
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Country | US
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Telephone | 850-830-2712
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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 | 22521
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License Number State | CO
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