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NPI Code Detail

MEDICARE: MASSAGE FITNESS, LLC

MEDICARE: MASSAGE FITNESS, LLC
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
1225700000XMassage Therapist0004653CO

General Provider Information

NPI Number : 1205230612
Entity Type Code : Organization
Provider Name (Legal Business Name) : MASSAGE FITNESS, LLC
Provider Business Mailing Address
First Line : 4475 STONEHAVEN DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-4897
Country : US
Telephone Number : 719-231-3081
Fax Number :
Provider Business Practice Location Address
First Line : 1255 LAKE PLAZA DR
Second Line : SUITE 268
City : COLORADO SPRINGS
State : CO
Zip : 80906-3500
Country : US
Telephone Number : 719-231-3081
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. JENNIFER CHEE
Credential : LMT
Telephone Number : 719-231-3081
Provider Enumeration Date : 10/14/2014
Last Update Date : 10/14/2014

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Directions to “MASSAGE FITNESS, LLC ” Practice Location

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