MEDICARE: SAPPHIRE VANPELT 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.0024681	CO

General Provider Information

NPI Number	:	1952059586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAPPHIRE VANPELT LMT

Provider Business Mailing Address
First Line	:	32993 SNOWSHOE RD UNIT 4
Second Line	:
City	:	EVERGREEN
State	:	CO
Zip	:	80439-7660
Country	:	US
Telephone Number	:	720-900-8513
Fax Number	:

Provider Business Practice Location Address
First Line	:	27905 MEADOW DR
Second Line	:
City	:	EVERGREEN
State	:	CO
Zip	:	80439-2110
Country	:	US
Telephone Number	:	720-900-8513
Fax Number	:

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

Provider Enumeration Date	:	03/14/2022
Last Update Date	:	03/14/2022

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