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Individual

MR. BRENT HANEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
2457 LARK DR, COLORADO SPRINGS, CO 80909-1863
(719) 287-9184
Mailing address
2457 LARK DR, COLORADO SPRINGS, CO 80909-1863
(719) 287-9184

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0016804
CO

Other

Enumeration date
11/10/2015
Last updated
11/16/2021
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