MEDICARE: EMMA KRISHER BA, 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.0015253	CO

General Provider Information

NPI Number	:	1073076998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA KRISHER BA, LMT

Provider Business Mailing Address
First Line	:	18773 E QUINN PL
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80015-2808
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13780 E RICE PL STE 103
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80015-1257
Country	:	US
Telephone Number	:	720-737-6026
Fax Number	:

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

Provider Enumeration Date	:	04/08/2019
Last Update Date	:	04/08/2019

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