Individual
SHANNON GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, MMP
Contact information
Practice address
6363 W 120TH AVE STE 310, BROOMFIELD, CO 80020-2406
(720) 768-3381
Mailing address
5 EVERGREEN ST, BROOMFIELD, CO 80020-2901
(720) 483-2034
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0023330
CO
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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