MEDICARE: VICTORIA L ADAMEK 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	CO MT-7044	CO

General Provider Information

NPI Number	:	1275852725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA L ADAMEK LMT

Provider Business Mailing Address
First Line	:	1355 S 8TH STR STE 205
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905
Country	:	US
Telephone Number	:	719-291-5445
Fax Number	:

Provider Business Practice Location Address
First Line	:	1355 S 8TH ST STE 205
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-7022
Country	:	US
Telephone Number	:	719-291-5445
Fax Number	:

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

Provider Enumeration Date	:	05/24/2010
Last Update Date	:	05/24/2010

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