Organization
SAN JUAN RIVER REHABILITATION LLC
Active
Organization
SAN JUAN RIVER REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID WILLIAM DOLAN LMT (OWNER)
(505) 947-0112
Entity
Organization
Contact information
Practice address
250 HOT SPRINGS BLVD, PAGOSA SPRINGS, CO 81147-4002
(505) 947-0112
Mailing address
PO BOX 2462, PAGOSA SPRINGS, CO 81147-2462
(505) 947-0112
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7499
CO
Other
Enumeration date
05/11/2012
Last updated
05/11/2012
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