Individual
JODIE MICHELLE WATHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
2425 MARSHALL ST, EDGEWATER, CO 80214-1017
(303) 859-9926
Mailing address
2425 MARSHALL ST, EDGEWATER, CO 80214-1017
(303) 859-9926
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1269638
—
CO
Enumeration date
05/24/2007
Last updated
07/08/2007
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