Provider Demographics
NPI:1689899023
Name:FRONT RANGE THERAPEUTIC MASSAGE CENTER INC
Entity Type:Organization
Organization Name:FRONT RANGE THERAPEUTIC MASSAGE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED NEUROMUSCU
Authorized Official - Phone:720-320-9008
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-0719
Mailing Address - Country:US
Mailing Address - Phone:720-320-9008
Mailing Address - Fax:303-423-3136
Practice Address - Street 1:9140 W 100TH AVE
Practice Address - Street 2:A6
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021
Practice Address - Country:US
Practice Address - Phone:720-320-9008
Practice Address - Fax:303-423-3136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2086601225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty