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NPI Code Detail

MEDICARE: DEVON MARIE MCKENZIE LMT

MEDICARE:   DEVON MARIE MCKENZIE  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
1225700000XMassage TherapistMT.0025425CO

General Provider Information

NPI Number : 1205617628
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVON MARIE MCKENZIE LMT
Provider Business Mailing Address
First Line : 1880 OFFICE CLUB PT STE 301
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-5020
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1880 OFFICE CLUB PT STE 301
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-5020
Country : US
Telephone Number : 719-212-1336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2023
Last Update Date : 10/11/2023

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Directions to “ DEVON MARIE MCKENZIE LMT” Practice Location

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