Individual
ANGIE BODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 S TEJON ST, 102A, COLORADO SPRINGS, CO 80903-2231
(719) 237-5690
Mailing address
102 S TEJON ST, COLORADO SPRINGS, CO 80903-2231
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0002605
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT.00002605
STATE LICENSE
CO
Enumeration date
01/06/2014
Last updated
01/07/2014
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