Individual
AVERY MIKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2095 W 6TH AVE STE 115, BROOMFIELD, CO 80020-1879
(720) 612-7429
Mailing address
2095 W 6TH AVE STE 115, BROOMFIELD, CO 80020-1879
(720) 612-7429
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0021173
CO
Other
Enumeration date
02/09/2018
Last updated
06/11/2019
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