Individual
WENDY L THEALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMT, B.A.
Contact information
Practice address
1800 30TH ST, STE 215, BOULDER, CO 80301-1088
(303) 444-1171
Mailing address
3195 ARNETT ST, #4, BOULDER, CO 80304-2924
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT 0014474
CO
Other
Enumeration date
02/09/2013
Last updated
02/09/2013
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