Organization Name: | BREKE EWTON |
NPI Number: | 1700274925 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BREKE EWTON (LICENSED MASSAGE THERAPIST) |
Mailing Address: | 3756 S Timberline Rd No. 207 Fort Collins |
State: | CO US |
Postal Code: | 805253499 |
Phone Number: | 9706822038 |
Fax Number: | |
NPI Enumeration Date: | 12/23/2014 |
NPI Last Update Date: | 12/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 16731 |
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. |