Doctor Name: | MS. MARY ALYCE CROSS |
NPI Number: | 1962706630 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CMT |
License Number: | 6304 |
Business Practice Address: | 14324 Us Highway 172n Ignacio, CO - 81137 |
Business Phone Number: | 9705636267 |
Business Fax Number: | |
Mailing Address: | 120 Pine Cone Dr, BAYFIELD |
State: | CO |
Postal Code: | 811229201 |
Phone Number: | 9707695776 |
Fax Number: | |
NPI Enumeration Date: | 01/10/2011 |
NPI Last Update Date: | 01/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 6304 |
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. |