Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MT.0017491 | CO |
NPI | 1003346487 |
---|---|
Provider Name | Petri Fiero-Akselsen |
First Address | Denver, CO 80223-3838 |
Second Address | Lakewood, CO 80215-3105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2017 |
Last Update Date | 18/06/2017 |