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General NPI Number Information
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NPI Number | 1992516132
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Entity Type | Organization
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Legal Business Name | BOTTS THERAPEUTIC MASSAGE, LLC
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 3505 AUSTIN BLUFFS PKWY STE 216
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-5754
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Country | US
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Telephone | 850-818-2051
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Fax |
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Provider Business Mailing Address
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Address Line | 9916 ANTLER CREEK DR
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City | PEYTON
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State | CO
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Zip | 80831-8492
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Country | US
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Telephone | 850-818-2051
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | ASHLEIGH ROSE BOTTS
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Credential | LMT, CNMT
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Telephone | 850-818-2051
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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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