Individual
ASHLEY LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
1601 POPLAR ST, LEADVILLE, CO 80461-3059
(719) 600-7306
Mailing address
1601 POPLAR ST, LEADVILLE, CO 80461-3059
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0012560
CO
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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