Individual
DIANA MOATS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
507 E RAINBOW BLVD STE C, SALIDA, CO 81201-2901
(719) 588-0152
Mailing address
329 E SACKETT AVE, SALIDA, CO 81201-2850
(719) 588-0152
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT0022715
CO
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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