Provider Demographics
NPI:1144737727
Name:KUGLIN, BETSY ANN (LMT)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:ANN
Last Name:KUGLIN
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 1:246 TAPADERO RD
Mailing Address - Street 2:
Mailing Address - City:BAILEY
Mailing Address - State:CO
Mailing Address - Zip Code:80421-1034
Mailing Address - Country:US
Mailing Address - Phone:720-545-8601
Mailing Address - Fax:
Practice Address - Street 1:26291 MAIN ST
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-8500
Practice Address - Country:US
Practice Address - Phone:303-838-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0016648225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist