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Individual

LINDA S NEWMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CMT, LMT, NMT

Contact information

Practice address
1401 N ELIZABETH ST, SUITE # D, PUEBLO, CO 81003-2158
(719) 544-3201
(719) 924-8276
Mailing address
619 W 23RD ST, PUEBLO, CO 81003-1805
(719) 544-3201
(719) 924-8176

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5320
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11181
PUEBLOMASSAGETHERAPISTLA
CO
01
11572957
CAQH PROVIDER NUMBER
01
293849600
OFFICE OF WORKERS COMPENSATION PROGRAMS DEPARTMENT OF LABOR PROVIDER NUMBER
01
32
PUEBLOMASSAGEISTLICENCE
CO
01
9016
AMTA MEMBERSHIP
CO
Enumeration date
11/20/2006
Last updated
04/08/2011
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