Individual
TIMOTHY MATTEO RUSSU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12380 W 64TH AVE, ARVADA, CO 80004-4016
(303) 467-5337
Mailing address
25 DOVER ST, LAKEWOOD, CO 80226-1274
(720) 625-1667
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019104
CO
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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