Provider Demographics
NPI:1619117710
Name:EARTHSONG, SUMMER (NCTMB)
Entity Type:Individual
Prefix:MS
First Name:SUMMER
Middle Name:
Last Name:EARTHSONG
Suffix:
Gender:F
Credentials:NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 PATTERSON RD STE 3
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8848
Mailing Address - Country:US
Mailing Address - Phone:970-243-1388
Mailing Address - Fax:970-243-1572
Practice Address - Street 1:1133 PATTERSON RD STE 3
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8848
Practice Address - Country:US
Practice Address - Phone:970-243-1388
Practice Address - Fax:970-243-1572
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist