Organization
MOUNTAIN STATE MEDICAL MASSAGE
Active
Other names
Mountain State Medical Massage, Mountain State Medical Massage
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY M NICKERSON LMT (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
08/19/2022
Last updated
01/18/2023
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