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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