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General NPI Number Information
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NPI Number | 1811256506
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Entity Type | Individual
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Provider Name | MS. MELISSA FRIEDMAN
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Gender | Female
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 201 WEST COLORADO AVE. NUGGET BUILDING, SUITE 208
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City | TELLURIDE
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State | CO
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Zip | 81435
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Country | US
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Telephone | 970-708-0778
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3753 201 WEST COLORADO AVE, NUGGET BUILDING, SUITE 208
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City | TELLURIDE
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State | CO
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Zip | 81435-3753
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Country | US
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Telephone | 970-708-0778
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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 | 13245
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License Number State | CO
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