Provider Demographics
NPI:1063647220
Name:ALBERTO, JOSE (RMT, NMT, RM)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:ALBERTO
Suffix:
Gender:M
Credentials:RMT, NMT, RM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2760 N ACADEMY BLVD
Mailing Address - Street 2:#135
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5324
Mailing Address - Country:US
Mailing Address - Phone:719-444-0708
Mailing Address - Fax:
Practice Address - Street 1:2760 N ACADEMY BLVD
Practice Address - Street 2:#135
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5324
Practice Address - Country:US
Practice Address - Phone:719-444-0708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2693225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist