Organization
MYOFASCIAL BODY WORK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNADETTE TIFFANY (OWNER)
(719) 240-3745
Entity
Organization
Contact information
Practice address
1307 FORTINO BLVD STE A, PUEBLO, CO 81008-2032
(719) 240-3745
(719) 223-4240
Mailing address
1307 FORTINO BLVD STE A, PUEBLO, CO 81008-2032
(719) 240-3745
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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