Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist |
NPI | 1023151511 |
---|---|
Provider Name | Ms. Lynn C, Daniels |
First Address | Brighton, CO 80601-2923 |
Second Address | Boulder, CO 80301-3596 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 08/07/2007 |