Individual
BETTY ANN MASSINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
4112 OUTLOOK BLVD, SUITE #96, PUEBLO, CO 81008-1667
(719) 562-6200
(719) 562-6225
Mailing address
4112 OUTLOOK BLVD, SUITE #96, PUEBLO, CO 81008-1667
(719) 562-6200
(719) 562-6225
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5342
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5342
STATE LICENSE
CO
Enumeration date
05/01/2012
Last updated
05/01/2012
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