Provider Demographics
NPI:1235188657
Name:JONES, SAMHITTA SUSANNE U (LAC MASSAGE THERAPIS)
Entity Type:Individual
Prefix:
First Name:SAMHITTA SUSANNE
Middle Name:U
Last Name:JONES
Suffix:
Gender:F
Credentials:LAC MASSAGE THERAPIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 29TH STREET
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-3315
Mailing Address - Country:US
Mailing Address - Phone:303-443-0260
Mailing Address - Fax:
Practice Address - Street 1:319 29TH STREET
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-3315
Practice Address - Country:US
Practice Address - Phone:303-443-0260
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO496171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist