Provider Demographics
NPI:1457660292
Name:MANCZUR-OUELLETTE, ARLA (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ARLA
Middle Name:
Last Name:MANCZUR-OUELLETTE
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 1:3288 S IDALIA ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-1728
Mailing Address - Country:US
Mailing Address - Phone:720-621-8266
Mailing Address - Fax:
Practice Address - Street 1:3288 S IDALIA ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-1728
Practice Address - Country:US
Practice Address - Phone:720-621-8266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5784225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist