Individual
ETHAN BLAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
5315 AUBREY WAY, COLORADO SPRINGS, CO 80919-3500
(719) 233-8576
Mailing address
5315 AUBREY WAY, COLORADO SPRINGS, CO 80919-3500
(719) 233-8576
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0018822
CO
Other
Enumeration date
04/20/2016
Last updated
04/20/2016
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