Provider Demographics
NPI:1881202455
Name:PIERCE, TJ (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:TJ
Middle Name:
Last Name:PIERCE
Suffix:
Gender:M
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 1:7561 S GRANT ST STE A3
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2626
Mailing Address - Country:US
Mailing Address - Phone:303-929-6585
Mailing Address - Fax:
Practice Address - Street 1:7561 S GRANT ST STE A3
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2626
Practice Address - Country:US
Practice Address - Phone:303-929-6585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0015238225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist