MEDICARE: MS. DEBANIA ALFREDA CHRISTIE C.L.M.T.

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.0017906	CO

General Provider Information

NPI Number	:	1073009411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBANIA ALFREDA CHRISTIE C.L.M.T.

Provider Business Mailing Address
First Line	:	705 S ALTON WAY UNIT 1A
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-1803
Country	:	US
Telephone Number	:	720-209-8774
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 S JAMAICA CT STE 250
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80014-4605
Country	:	US
Telephone Number	:	720-688-0293
Fax Number	:

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

Provider Enumeration Date	:	07/09/2018
Last Update Date	:	06/11/2019

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