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General NPI Number Information
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NPI Number | 1780317305
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Entity Type | Individual
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Provider Name | SAMANTHA DEAN LMT
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Gender | Female
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 07/01/2022
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Provider Practice Location Address
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Address Line | 7705 WADSWORTH BLVD # 112
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City | ARVADA
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State | CO
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Zip | 80003-2144
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Country | US
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Telephone | 760-586-3727
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Fax |
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Provider Business Mailing Address
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Address Line | 8340 GARLAND DR
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City | ARVADA
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State | CO
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Zip | 80005-2257
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Country | US
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Telephone | 760-586-3727
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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 | 0024314
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License Number State | CO
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