Individual
KEVIN RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMT, LMT, LMTI
Contact information
Practice address
1240 LINDEN AVE APT A, BOULDER, CO 80304-1549
(303) 249-1054
Mailing address
1240 LINDEN AVE APT A, BOULDER, CO 80304-1549
(303) 249-1054
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
5170
NM
225700000X
Massage Therapist
Primary
8934
CO
Other
Enumeration date
01/05/2010
Last updated
05/12/2011
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