MEDICARE: MRS. JOCELYNE R TAYLOR

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

General Provider Information

NPI Number	:	1295035699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOCELYNE R TAYLOR

Provider Business Mailing Address
First Line	:	711 S TEJON ST
Second Line	:	SUITE 200
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-4049
Country	:	US
Telephone Number	:	719-651-5848
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 S TEJON ST
Second Line	:	SUITE 200
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-4049
Country	:	US
Telephone Number	:	719-651-5848
Fax Number	:

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

Provider Enumeration Date	:	11/01/2010
Last Update Date	:	12/14/2010

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