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Individual

TRACI LYNN DWORSHAKWINTERBOTTOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1710 W COLORADO AVE UNIT B, COLORADO SPRINGS, CO 80904-3886
(719) 271-5200
Mailing address
5724 ADRIENNE CT, COLORADO SPRINGS, CO 80906-8257
(719) 271-5200

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
711417
CO

Other

Enumeration date
12/05/2008
Last updated
12/05/2008
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