Individual
MICHAEL ANTHONY COFFEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
58 GLEN ROYAL DR, PUEBLO, CO 81005-2263
(719) 994-8655
Mailing address
58 GLEN ROYAL DR, PUEBLO, CO 81005-2263
(719) 994-8655
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0015292
CO
Other
Enumeration date
04/08/2014
Last updated
04/08/2014
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