Provider Demographics
NPI:1841412533
Name:HEPPARD, ROSE M (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:M
Last Name:HEPPARD
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12236 UTICA ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-5640
Mailing Address - Country:US
Mailing Address - Phone:303-990-1113
Mailing Address - Fax:
Practice Address - Street 1:8472 FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3818
Practice Address - Country:US
Practice Address - Phone:303-429-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor