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General NPI Number Information
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NPI Number | 1992130041
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Entity Type | Individual
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Provider Name | MRS. HEATHER ANNE GUNNERSON
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Gender | Female
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Dates
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Enumeration Date | 09/09/2013
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 1635 AURORA CT MS F743 FIFTH FLOOR, SUITE 5501
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City | AURORA
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State | CO
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Zip | 80045-2541
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Country | US
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Telephone | 720-848-1090
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Fax |
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Provider Business Mailing Address
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Address Line | 2362 E 110TH PL
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City | NORTHGLENN
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State | CO
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Zip | 80233-4652
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Country | US
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Telephone | 970-222-2299
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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 | 1668
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License Number State | CO
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