Individual
MR. YEVGENIY FEDOROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1800 30TH ST STE 215, BOULDER, CO 80301-1026
(303) 444-1171
Mailing address
1800 30TH ST STE 215, BOULDER, CO 80301-1026
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0017306
CO
Other
Enumeration date
11/02/2015
Last updated
11/02/2015
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