Provider Demographics
NPI:1265644330
Name:ADVANCED MASSAGE SPECIALISTS, LLC
Entity Type:Organization
Organization Name:ADVANCED MASSAGE SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CMT, CNMT
Authorized Official - Phone:303-763-9175
Mailing Address - Street 1:3333 S. WADSWORTH BLVD.
Mailing Address - Street 2:SUITE 214
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227
Mailing Address - Country:US
Mailing Address - Phone:303-763-9175
Mailing Address - Fax:303-984-9980
Practice Address - Street 1:3333 S. WADSWORTH BLVD.
Practice Address - Street 2:SUITE 214
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227
Practice Address - Country:US
Practice Address - Phone:303-763-9175
Practice Address - Fax:303-984-9980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty