MEDICARE: HEATHER MARIE NASH RMT, CNMT

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.0001499	CO

General Provider Information

NPI Number	:	1932546116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER MARIE NASH RMT, CNMT

Provider Business Mailing Address
First Line	:	2216 N UNION BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1834
Country	:	US
Telephone Number	:	719-332-4164
Fax Number	:

Provider Business Practice Location Address
First Line	:	5525 N UNION BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1969
Country	:	US
Telephone Number	:	719-332-4164
Fax Number	:

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

Provider Enumeration Date	:	05/29/2013
Last Update Date	:	05/29/2013

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