Iris Jeanette Diaz Cassidy, CMT. COMT
Individual provider Active NPI Massage Therapist · Salida, CO
NPI 1598089518 · NPPES record last updated Mar 19, 2010
Key facts
- NPI
- 1598089518
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 3543 (CO)
- Practice address
- 1548 G Street
#8 La Placita
Salida, CO 81201 - Phone
- (719) 207-1402
- NPI assigned
- Mar 19, 2010
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 3543 | CO | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 3543 | CO | Yes |
Addresses
Primary practice location
1548 G Street
#8 La Placita
Salida, CO 81201
Mailing address
1548 G Street
#8 La Placita
Salida, CO 81201
Phone (719) 207-1402
Other providers in Salida, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.