Individual
COBIANA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6305 W 6TH AVE, LAKEWOOD, CO 80214-2319
(720) 218-8539
Mailing address
6305 W 6TH AVE, LAKEWOOD, CO 80214-2319
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0005052
CO
Other
Enumeration date
02/01/2016
Last updated
02/01/2016
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