Provider Demographics
NPI:1205125853
Name:FRAZIER, SUMMER LEE (LMT)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:LEE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 WABASH ST
Mailing Address - Street 2:#11-203
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-3191
Mailing Address - Country:US
Mailing Address - Phone:970-222-1379
Mailing Address - Fax:
Practice Address - Street 1:3501 S MASON ST
Practice Address - Street 2:UNIT #4
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2627
Practice Address - Country:US
Practice Address - Phone:970-222-1379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225700000X225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist