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General NPI Number Information
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NPI Number | 1932757176
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Entity Type | Individual
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Provider Name | LISA RAE SPANO LMT
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Gender | Female
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Dates
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Enumeration Date | 08/30/2019
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | 1400 W 122ND AVE STE 140
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City | WESTMINSTER
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State | CO
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Zip | 80234-3440
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Country | US
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Telephone | 888-664-4222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 746644
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City | ARVADA
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State | CO
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Zip | 80006-6644
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Country | US
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Telephone | 720-862-7739
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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 |
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License Number State |
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