MEDICARE: MR. JEFFREY BALDWIN CMT, RMT

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-12693	CO

General Provider Information

NPI Number	:	1134499254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY BALDWIN CMT, RMT

Provider Business Mailing Address
First Line	:	5125 S COLLEGE AVE
Second Line	:	SUITE A
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3959
Country	:	US
Telephone Number	:	303-319-4325
Fax Number	:

Provider Business Practice Location Address
First Line	:	5125 S COLLEGE AVE
Second Line	:	SUITE A
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3959
Country	:	US
Telephone Number	:	303-319-4325
Fax Number	:

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

Provider Enumeration Date	:	01/05/2012
Last Update Date	:	01/05/2012

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