MEDICARE: CORI DUCOMBS

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.0020210	CO

General Provider Information

NPI Number	:	1265109243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORI DUCOMBS

Provider Business Mailing Address
First Line	:	2214 E 17TH AVE APT 1
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-1220
Country	:	US
Telephone Number	:	720-394-9313
Fax Number	:

Provider Business Practice Location Address
First Line	:	2214 E 17TH AVE APT 1
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-1220
Country	:	US
Telephone Number	:	720-394-9313
Fax Number	:

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

Provider Enumeration Date	:	08/26/2021
Last Update Date	:	08/26/2021

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Directions to “ CORI DUCOMBS ” Practice Location

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