Individual
DEVERE KEEN GAMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.T
Contact information
Practice address
755 E 2ND AVE, SUITE 2C, DURANGO, CO 81301-5498
(970) 946-1051
Mailing address
755 E 2ND AVE, SUITE 2C, DURANGO, CO 81301-5498
(970) 946-1051
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3709
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3709
STATE LICENSE
CO
Enumeration date
04/11/2013
Last updated
04/11/2013
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