Provider Demographics
NPI:1417582248
Name:AURORA PROFESSIONAL MASSAGE
Entity Type:Organization
Organization Name:AURORA PROFESSIONAL MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:303-829-2907
Mailing Address - Street 1:15200 E GIRARD AVE STE 1900
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-5048
Mailing Address - Country:US
Mailing Address - Phone:303-829-2907
Mailing Address - Fax:
Practice Address - Street 1:15200 E GIRARD AVE STE 1900
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-5048
Practice Address - Country:US
Practice Address - Phone:303-829-2907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty