Doctor Name: | MARJORY LYNN PHILIPPON |
NPI Number: | 1417292426 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CLT, RMT |
License Number: | 2390 |
Business Practice Address: | 1537 Florida Rd Suite 105 Durango, CO - 813015792 |
Business Phone Number: | 9703856708 |
Business Fax Number: | 9702478911 |
Mailing Address: | 3270 E 4th Ave, DURANGO |
State: | CO |
Postal Code: | 813016002 |
Phone Number: | 9707694653 |
Fax Number: | 9702478911 |
NPI Enumeration Date: | 12/02/2012 |
NPI Last Update Date: | 09/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 2390 |
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. |