Provider Demographics
NPI:1003296765
Name:MIRFIELD, CARRIE (LMT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MIRFIELD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8725 WADSWORTH BLVD., STE A
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003
Mailing Address - Country:US
Mailing Address - Phone:303-425-7298
Mailing Address - Fax:303-940-8330
Practice Address - Street 1:8725 WADSWORTH BLVD., STE A
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003
Practice Address - Country:US
Practice Address - Phone:303-425-7298
Practice Address - Fax:303-940-8330
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0013340225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist