Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 7493 | CO |
NPI | 1013279363 |
---|---|
Provider Name | Nicholas Rostocil |
First Address | Denver, CO 80212-2104 |
Second Address | Denver, CO 80212-2104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2012 |
Last Update Date | 15/06/2012 |