Organization
GREEN LEAF MASSAGE CENTER. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANETTE ANDREA SIRAVO (OWNR)
(303) 423-6091
Entity
Organization
Contact information
Practice address
11890 W.64TH AVENUE, ARVADA, CO 80004
(303) 423-6091
Mailing address
11890 W.64TH AVENUE, ARVADA, CO 80004
(303) 423-6091
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
MT-9224
CO
Other
Enumeration date
04/08/2011
Last updated
04/08/2011
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