Individual
KASAUNDRA SHALOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
740 BURBANK ST, BROOMFIELD, CO 80020-1658
(720) 589-4902
Mailing address
740 BURBANK ST, BROOMFIELD, CO 80020-1658
(720) 589-4902
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-0020445
CO
Other
Enumeration date
07/23/2020
Last updated
07/23/2020
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