Provider Demographics
NPI:1780256495
Name:VENZOR, ROSLYN (LMT)
Entity type:Individual
Prefix:
First Name:ROSLYN
Middle Name:
Last Name:VENZOR
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 1:8616 MEADOWLARK CIR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-2161
Mailing Address - Country:US
Mailing Address - Phone:970-305-6647
Mailing Address - Fax:
Practice Address - Street 1:200 W BELLEVIEW AVE UNIT 120
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-6600
Practice Address - Country:US
Practice Address - Phone:970-305-6647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty