Individual
MEGAN LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CNMT
Contact information
Practice address
3055 AUSTIN BLUFFS PKWY, COLORADO SPRINGS, CO 80918-5748
(719) 266-8884
Mailing address
4667 POLEPLANT DR, COLORADO SPRINGS, CO 80918-5257
(719) 337-8458
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0018558
CO
Other
Enumeration date
12/08/2016
Last updated
02/13/2018
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