Provider Demographics
NPI:1972194157
Name:TRINITY MASSAGE THERAPY OF COLORADO LLC
Entity Type:Organization
Organization Name:TRINITY MASSAGE THERAPY OF COLORADO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-396-3614
Mailing Address - Street 1:2162 DERBY HILL DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-7314
Mailing Address - Country:US
Mailing Address - Phone:970-396-3614
Mailing Address - Fax:
Practice Address - Street 1:1530 BOISE AVE SUITE 204A
Practice Address - Street 2:SUITE 204-A
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-5031
Practice Address - Country:US
Practice Address - Phone:970-396-3614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty