Organization
ELITE MASSAGE
Active
Other names
Elite Medical Massage
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLYDE JOHNSON DC MS-REHAB MS-NUTRI (OWNER)
(720) 515-8002
Entity
Organization
Contact information
Practice address
5950 S WILLOW DR STE 200, GREENWOOD VILLAGE, CO 80111-5144
(720) 515-8002
Mailing address
5950 S WILLOW DR STE 200, GREENWOOD VILLAGE, CO 80111-5144
(720) 515-8002
(303) 741-2676
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
CHR.0006922
CO
261QP2000X
Physical Therapy Clinic/Center
CHR.0006922
CO
261QP3300X
Pain Clinic/Center
CHR.0006922
CO
Other
Enumeration date
02/10/2017
Last updated
02/14/2017
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