Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 3999 | CO |
NPI | 1013236587 |
---|---|
Provider Name | Christopher Furer |
First Address | Durango, CO 81301-5472 |
Second Address | Durango, CO 81301-5472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2010 |
Last Update Date | 24/05/2010 |