MEDICARE: MYRANDA SUZANNE COLBY LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT.0027078	CO

General Provider Information

NPI Number	:	1053262469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYRANDA SUZANNE COLBY LMT

Provider Business Mailing Address
First Line	:	612 1/2 PIONEER RD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81504-5246
Country	:	US
Telephone Number	:	636-698-8985
Fax Number	:

Provider Business Practice Location Address
First Line	:	2456 INDUSTRIAL BLVD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1328
Country	:	US
Telephone Number	:	636-698-8985
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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