Doctor Name: | JESSICA LEE MANKIN |
NPI Number: | 1336325836 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.T. |
License Number: | MT.0004892 |
Business Practice Address: | 151 S College Ave # A1 Fort Collins, CO - 805242864 |
Business Phone Number: | 9706904946 |
Business Fax Number: | |
Mailing Address: | 151 S College Ave # A1, FORT COLLINS |
State: | CO |
Postal Code: | 805242864 |
Phone Number: | 9706904946 |
Fax Number: | |
NPI Enumeration Date: | 01/14/2008 |
NPI Last Update Date: | 01/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT.0004892 |
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. |