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NPI Code Detail

MEDICARE: ELIZABETH PALKA MT, NMT

MEDICARE: ELIZABETH PALKA MT, NMT
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.002587CO

General Provider Information

NPI Number : 1356093728
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH PALKA MT, NMT
Provider Business Mailing Address
First Line : 1712 W UINTAH ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-2958
Country : US
Telephone Number : 719-247-8441
Fax Number :
Provider Business Practice Location Address
First Line : 1712 W UINTAH ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-2958
Country : US
Telephone Number : 719-247-8441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2022
Last Update Date : 01/26/2022

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Directions to “ ELIZABETH PALKA MT, NMT” Practice Location

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