Individual
JUSTIN EDWARD TALLANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1901 KIPLING ST, LAKEWOOD, CO 80215-2822
(720) 999-8550
Mailing address
750 TABOR ST APT 25, LAKEWOOD, CO 80401-4731
(303) 901-3671
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0023462
CO
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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