Provider Demographics
NPI:1932745809
Name:GUYNE, JENNIFER (MT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GUYNE
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7760 W 87TH DR APT P
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-1656
Mailing Address - Country:US
Mailing Address - Phone:970-946-4692
Mailing Address - Fax:
Practice Address - Street 1:11890 W 64TH AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-4324
Practice Address - Country:US
Practice Address - Phone:303-467-5337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0023063225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0023063OtherMASSAGE THERAPIST