MEDICARE: MS. BETH E SALOMONIS 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.0014860	CO

General Provider Information

NPI Number	:	1194152181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BETH E SALOMONIS LMT

Provider Business Mailing Address
First Line	:	1170 OLIVE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-4859
Country	:	US
Telephone Number	:	917-749-5459
Fax Number	:

Provider Business Practice Location Address
First Line	:	1057 S WADSWORTH BLVD
Second Line	:	SUITE 90
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-4360
Country	:	US
Telephone Number	:	303-989-3656
Fax Number	:

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

Provider Enumeration Date	:	10/04/2013
Last Update Date	:	10/04/2013

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