Provider Demographics
NPI:1235505561
Name:GROOME, VERONICA (LMT)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:GROOME
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:PO BOX 221526
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-1014
Mailing Address - Country:US
Mailing Address - Phone:303-961-3668
Mailing Address - Fax:
Practice Address - Street 1:21577 E MANSFIELD DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-7472
Practice Address - Country:US
Practice Address - Phone:303-961-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-21
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO962416225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist