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Individual

DANA DENECE RYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNMT, COZ

Contact information

Practice address
2 BELLFLOWER CT, PUEBLO, CO 81001-1101
(719) 641-2397
Mailing address
2 BELLFLOWER CT, PUEBLO, CO 81001-1101
(719) 641-2397

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0020624
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
COZ.0710321
CO
05
MT.0020624
CO
Enumeration date
11/14/2019
Last updated
11/14/2019
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