Individual
MATTHEW C JOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
514 28 1/4 RD UNIT 1, GRAND JUNCTION, CO 81501-4961
(970) 242-8162
Mailing address
125 S ELM ST APT 5, FRUITA, CO 81521-2630
(970) 639-2629
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0018908
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018908
COLORADO DIVISION OF REGULATORY AGENCIES
CO
Enumeration date
04/25/2019
Last updated
06/11/2019
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