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General NPI Number Information
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NPI Number | 1801175526
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Entity Type | Individual
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Provider Name | ROSE MARIE WILLIAMS MASSAGE THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 08/11/2011
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 30940 STAGECOACH BLVD STE 110
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City | EVERGREEN
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State | CO
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Zip | 80439-7984
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Country | US
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Telephone | 303-674-1594
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Fax | 303-674-9870
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Provider Business Mailing Address
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Address Line | 4817 S XENOPHON WAY
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City | MORRISON
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State | CO
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Zip | 80465-1776
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Country | US
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Telephone | 720-205-1144
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MT-7397
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License Number State | CO
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