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NPI Code Detail

MEDICARE: ROSE MASSAGE THERAPY, LLC

MEDICARE: ROSE MASSAGE THERAPY, LLC
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 Therapist

General Provider Information

NPI Number : 1396563011
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROSE MASSAGE THERAPY, LLC
Provider Business Mailing Address
First Line : 955 N GREENWOOD ST
Second Line :
City : PUEBLO
State : CO
Zip : 81003-2927
Country : US
Telephone Number : 719-256-0797
Fax Number : 719-285-0781
Provider Business Practice Location Address
First Line : 955 N GREENWOOD ST
Second Line :
City : PUEBLO
State : CO
Zip : 81003-2927
Country : US
Telephone Number : 719-256-0797
Fax Number : 719-285-0781
Authorized Official
Title or Position : OWNER
Name : MS. AMY ROSE
Credential : RN, LMT, CNMT
Telephone Number : 719-821-0377
Provider Enumeration Date : 10/01/2024
Last Update Date : 10/01/2024

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Directions to “ROSE MASSAGE THERAPY, LLC ” Practice Location

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