Individual
HARRY MANFRED WALDEN BANEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSC CMT
Contact information
Practice address
4602 PLETTNER LN, UNIT 3A, EVERGREEN, CO 80439-7380
(303) 565-0791
Mailing address
4602 PLETTNER LN, UNIT 3A, EVERGREEN, CO 80439-7380
(303) 565-0791
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1873
CO
Other
Enumeration date
01/14/2009
Last updated
08/26/2013
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