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General NPI Number Information
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NPI Number | 1912715665
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Entity Type | Organization
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Legal Business Name | JANELLE'S MASSAGE THERAPY LLC
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Dates
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Enumeration Date | 12/27/2024
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 503 N MAIN ST STE 658
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City | PUEBLO
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State | CO
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Zip | 81003-3132
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Country | US
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Telephone | 719-299-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 505 SCRANTON AVE
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City | PUEBLO
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State | CO
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Zip | 81004-1322
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Country | US
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Telephone | 719-299-8888
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANELLE K MUNOZ
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Credential |
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Telephone | 719-299-8888
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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 |
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License Number State |
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