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General NPI Number Information
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NPI Number | 1780648386
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Entity Type | Organization
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Legal Business Name | MEDICAL MASAGE CENTER, INC.
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8370 W COAL MINE AVE SUITE 106
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City | LITTLETON
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State | CO
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Zip | 80123-4401
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Country | US
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Telephone | 303-979-0342
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Fax | 303-979-3872
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Provider Business Mailing Address
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Address Line | 8370 W COAL MINE AVE SUITE 106
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City | LITTLETON
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State | CO
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Zip | 80123-4401
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Country | US
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Telephone | 303-979-0342
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Fax | 303-979-3872
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Authorized Official
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Title or Position | OWNER
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Name | SUE JERNIGAN
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Credential | R.N.
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Telephone | 303-979-0342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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