Brook Jordan, LMT

Individual provider Active NPI Massage Therapist · Black Hawk, CO

NPI 1083374698 · NPPES record last updated Dec 22, 2021

Key facts

NPI
1083374698
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
Practice address
514 Coyote Cir
Black Hawk, CO 80422-8712
Phone
(303) 408-6138
NPI assigned
Dec 22, 2021
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X Yes

Addresses

Primary practice location

514 Coyote Cir
Black Hawk, CO 80422-8712

Mailing address

514 Coyote Cir
Black Hawk, CO 80422-8712

Other providers in Black Hawk, CO

All providers in Black Hawk, CO · Massage Therapist in Colorado

Sources for this page

Verify at the official NPI Registry.