Provider Demographics
NPI:1144453838
Name:SANTOS, BETH ANN (RMT, NCTMB)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:SANTOS
Suffix:
Gender:F
Credentials:RMT, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7330 COTTON DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-6392
Mailing Address - Country:US
Mailing Address - Phone:719-930-5536
Mailing Address - Fax:719-260-5578
Practice Address - Street 1:7075 CAMPUS DR STE 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-6524
Practice Address - Country:US
Practice Address - Phone:719-930-5536
Practice Address - Fax:719-260-5578
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO759225700000X
CO387714-00225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist