Provider Demographics
NPI:1598051096
Name:GOMEZ, YUN KYONG (CMT)
Entity Type:Individual
Prefix:MRS
First Name:YUN
Middle Name:KYONG
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 DEER TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-6815
Mailing Address - Country:US
Mailing Address - Phone:970-258-7111
Mailing Address - Fax:
Practice Address - Street 1:6 HILLCREST PLAZA WAY
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5876
Practice Address - Country:US
Practice Address - Phone:970-258-7111
Practice Address - Fax:970-417-4674
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20081484885225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist