MEDICARE: JAIMIE L KULIKOWSKI 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	MT.0014226	CO

General Provider Information

NPI Number	:	1376043638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIMIE L KULIKOWSKI LMT

Provider Business Mailing Address
First Line	:	1191 S YOSEMITE WAY UNIT 45
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-2228
Country	:	US
Telephone Number	:	303-319-5318
Fax Number	:

Provider Business Practice Location Address
First Line	:	1191 S YOSEMITE WAY UNIT 45
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-2228
Country	:	US
Telephone Number	:	303-319-5318
Fax Number	:

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

Provider Enumeration Date	:	02/13/2018
Last Update Date	:	07/30/2019

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