Individual
YANDI CAKRASENJAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, MMP
Contact information
Practice address
925 W US HIGHWAY 50, PUEBLO, CO 81008-1606
(720) 600-9994
Mailing address
359 E ENTERPRISE DR STE 7, PUEBLO WEST, CO 81007-1443
(720) 600-9994
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0023692
CO
Other
Enumeration date
01/31/2022
Last updated
01/27/2026
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