Organization
JENNY NICKERSON
Active
Organization
JENNY NICKERSON
Active
Parent organization
JENNY NICKERSON
Other names
Mountain State Medical Massage
Organization subpart
Yes
Provider details
NPI number
Legal business name
JENNY NICKERSON
Authorized official
JENNY NICKERSON (OWNER)
(720) 841-1042
Entity
Organization
Contact information
Practice address
6970 S HOLLY CIR, CENTENNIAL, CO 80112-6296
(720) 841-1042
Mailing address
4767 S ODESSA ST, CENTENNIAL, CO 80015-3449
(720) 841-1042
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
02/17/2023
Last updated
09/06/2023
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