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Individual

NYKE SOUL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CMT

Contact information

Practice address
600 GRANT ST, 350, DENVER, CO 80203-3524
(303) 309-6704
Mailing address
1265 DOWNING ST, 101, DENVER, CO 80218-2112

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8387
CO

Other

Enumeration date
11/11/2010
Last updated
11/11/2010
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