Individual
MELINDA PEMBERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2518 LAKE DR, LOVELAND, CO 80538-3135
(970) 481-5676
Mailing address
PO BOX 1474, LOVELAND, CO 80539-1474
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT0019746
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT0019746
MASSAGE THERAPY
CO
Enumeration date
08/17/2020
Last updated
08/17/2020
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