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Individual

JESSICA NICOLE CAINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
155 COOK ST STE 321, DENVER, CO 80206-5317
(303) 355-1234
Mailing address
4363 S QUEBEC ST APT 2112, DENVER, CO 80237-2675
(720) 475-6342

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0007639
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
82-1722007
IRS
Enumeration date
09/25/2017
Last updated
09/25/2017
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