Individual
BEATRICE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1177 UPPER BEAR CREEK RD, EVERGREEN, CO 80439-4241
(303) 726-4276
Mailing address
1177 UPPER BEAR CREEK RD, EVERGREEN, CO 80439-4241
(303) 726-4276
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12204
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12201
STATE REGISTRATION
CO
Enumeration date
08/09/2013
Last updated
08/09/2013
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