Individual
TINA MARIE SHANTELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1019 23RD AVE, LONGMONT, CO 80501
(720) 425-2192
Mailing address
1019 23RD AVE, LONGMONT, CO 80501-1111
(720) 425-2192
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7271
CO
Other
Enumeration date
07/06/2011
Last updated
11/20/2012
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