Provider Demographics
NPI:1598548455
Name:GARCIA, CHERELLE B (LMT)
Entity Type:Individual
Prefix:
First Name:CHERELLE
Middle Name:B
Last Name:GARCIA
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 1:6187 W GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5437
Mailing Address - Country:US
Mailing Address - Phone:720-365-6937
Mailing Address - Fax:
Practice Address - Street 1:8120 SHERIDAN BLVD STE 101B
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80003-6141
Practice Address - Country:US
Practice Address - Phone:720-365-6937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0022113225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist