Provider Demographics
NPI:1649330358
Name:MONTROSE MASSAGE THERAPY, INC.
Entity type:Organization
Organization Name:MONTROSE MASSAGE THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STUBBLEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:970-252-0602
Mailing Address - Street 1:15970 5790 RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-9614
Mailing Address - Country:US
Mailing Address - Phone:970-252-0602
Mailing Address - Fax:
Practice Address - Street 1:5 HILLCREST PLAZA WAY
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5876
Practice Address - Country:US
Practice Address - Phone:970-252-0602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty