Doctor Name: | MARI LETENDRE |
NPI Number: | 1063841021 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | MT.0001853 |
Business Practice Address: | 917 W Colorado Ave Ste 100 Colorado Springs, CO - 809051517 |
Business Phone Number: | 7196354842 |
Business Fax Number: | |
Mailing Address: | 917 W Colorado Ave, Ste 100 COLORADO SPRINGS |
State: | CO |
Postal Code: | 809051517 |
Phone Number: | 7196354842 |
Fax Number: | |
NPI Enumeration Date: | 11/10/2013 |
NPI Last Update Date: | 11/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT.0001853 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |