Doctor Name: | BRETT KINGSBURY |
NPI Number: | 1578960183 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.M.T |
License Number: | 0017103 |
Business Practice Address: | 514 28 1/4 Rd Suite 4 Grand Junction, CO - 815014961 |
Business Phone Number: | 9706445255 |
Business Fax Number: | 9702833230 |
Mailing Address: | 514 28 1/4 Rd, Suite 4 GRAND JUNCTION |
State: | CO |
Postal Code: | 815014961 |
Phone Number: | 9706445255 |
Fax Number: | 9702833230 |
NPI Enumeration Date: | 11/25/2014 |
NPI Last Update Date: | 12/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 0017103 |
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. |