Individual
SHANNON GLORIOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
11371 NIAGARA ST, THORNTON, CO 80233-5542
(312) 351-5245
Mailing address
11371 NIAGARA ST, THORNTON, CO 80233-5542
(312) 351-5245
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0015496
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT.0015496
STATE LICENSE
CO
Enumeration date
09/06/2014
Last updated
09/06/2014
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