Individual
GREGORY LAVENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT, MMP
Contact information
Practice address
128 W 14TH ST, DURANGO, CO 81301-5100
(970) 880-1260
Mailing address
86 PANORAMA, DURANGO, CO 81303-6520
(302) 547-5558
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0024302
CO
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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