Laura Graham

Individual provider Active NPI Massage Therapist · Longmont, CO

NPI 1043689649 · NPPES record last updated Sep 24, 2015

Key facts

NPI
1043689649
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT.0013833 (CO)
Practice address
1860 Industrial Cir
Longmont, CO 80501-6559
Phone
(303) 682-2440
NPI assigned
Sep 24, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MT.0013833COMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT.0013833 CO Yes

Addresses

Primary practice location

1860 Industrial Cir
Longmont, CO 80501-6559

Mailing address

1860 Industrial Cir
Longmont, CO 80501-6559

Other providers in Longmont, CO

All providers in Longmont, CO · Massage Therapist in Colorado

Sources for this page

Verify at the official NPI Registry.