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Organization

BEACHERSEN, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LINDSAY BEACH PETERSEN (OWNER/OPERATOR)
(970) 426-9226
Entity
Organization

Contact information

Practice address
2302 COUNTY ROAD 234, DURANGO, CO 81301-8206
(970) 426-9226
Mailing address
2302 COUNTY ROAD 234, DURANGO, CO 81301-8206
(970) 426-9226

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1438
CO
374J00000X
Doula

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1518289669
INDIVIDUAL NPI
CO
Enumeration date
09/17/2012
Last updated
09/17/2012
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