MEDICARE: REGINA MARIE HOBER 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	3971	CO

General Provider Information

NPI Number	:	1710415187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA MARIE HOBER LMT

Provider Business Mailing Address
First Line	:	1100 MOORE DR
Second Line	:
City	:	FLORENCE
State	:	CO
Zip	:	81226-9590
Country	:	US
Telephone Number	:	719-371-1071
Fax Number	:

Provider Business Practice Location Address
First Line	:	1216 MAIN ST
Second Line	:
City	:	CANON CITY
State	:	CO
Zip	:	81212-3506
Country	:	US
Telephone Number	:	719-371-1071
Fax Number	:

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

Provider Enumeration Date	:	05/30/2017
Last Update Date	:	05/30/2017

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Directions to “ REGINA MARIE HOBER LMT” Practice Location

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