Individual
MR. JASON CHRISTOPHER MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
41050 LAMBORN MESA RD, PAONIA, CO 81428-6433
(267) 670-9535
Mailing address
41050 LAMBORN MESA RD, PAONIA, CO 81428-6433
(267) 670-9535
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24361
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24361
DEPARTMENT OF REGULATORY AGENCIES - COLORADO
CO
Enumeration date
10/12/2021
Last updated
10/12/2021
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