Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MT.0013340 | CO |
NPI | 1003296765 |
---|---|
Provider Name | Carrie Mirfield |
First Address | Arvada, CO 80003 |
Second Address | Arvada, CO 80003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2015 |
Last Update Date | 08/06/2015 |