Individual
DIANA MARIE PRADO CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
525 15TH AVE LOT 26, LONGMONT, CO 80501-3351
(720) 338-2822
Mailing address
525 15TH AVE LOT 26, LONGMONT, CO 80501-3351
(720) 338-2822
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0017321
CO
Other
Enumeration date
05/31/2015
Last updated
05/31/2015
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