Kim Jenon Baldwin

Individual provider Active NPI Massage Therapist · Rifle, CO

NPI 1063710143 · NPPES record last updated Mar 14, 2011

Key facts

NPI
1063710143
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT7258 (CO)
Practice address
201 W 3Rd St
Rifle, CO 81650-2245
Phone
(970) 379-6418
Fax
(970) 625-5505
NPI assigned
Mar 14, 2011
Sex
Female
Sole proprietor
Yes

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
MT7258COMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT7258 CO Yes

Addresses

Primary practice location

201 W 3Rd St
Rifle, CO 81650-2245

Mailing address

PO Box 1022
201 W 3Rd St
Rifle, CO 81650-1022
Phone (970) 379-6418

Other providers in Rifle, CO

All providers in Rifle, CO · Massage Therapist in Colorado

Sources for this page

Verify at the official NPI Registry.