MEDICARE: MRS. RACHAEL HUDSON 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	6158	CO

General Provider Information

NPI Number	:	1992017339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHAEL HUDSON LMT

Provider Business Mailing Address
First Line	:	12191 W 64TH AVE STE 306
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80004-4030
Country	:	US
Telephone Number	:	303-249-8439
Fax Number	:

Provider Business Practice Location Address
First Line	:	12191 W 64TH AVE STE 306
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80004-4030
Country	:	US
Telephone Number	:	303-249-8439
Fax Number	:

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

Provider Enumeration Date	:	07/13/2010
Last Update Date	:	01/22/2015

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