MEDICARE: JOYCE CHAVEZ MT

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	MT0007904	CO

General Provider Information

NPI Number	:	1649693995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE CHAVEZ MT

Provider Business Mailing Address
First Line	:	8056 COUNTY ROAD 69.1
Second Line	:
City	:	TRINIDAD
State	:	CO
Zip	:	81082-9716
Country	:	US
Telephone Number	:	719-859-3879
Fax Number	:

Provider Business Practice Location Address
First Line	:	8056 COUNTY ROAD 69.1
Second Line	:
City	:	TRINIDAD
State	:	CO
Zip	:	81082-9716
Country	:	US
Telephone Number	:	719-859-3879
Fax Number	:

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

Provider Enumeration Date	:	01/22/2014
Last Update Date	:	01/22/2014

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Directions to “ JOYCE CHAVEZ MT” Practice Location

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