Basic Information
| Provider Information | |||||||||
| NPI: | 1912356585 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BEHRENS | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | CATHERINE | ||||||||
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| Credential: | L.M.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50000 E 112TH AVE | ||||||||
| Address2: | |||||||||
| City: | BENNETT | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801029423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038865014 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2418 E BRIDGE ST | ||||||||
| Address2: | |||||||||
| City: | BRIGHTON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806012546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036558699 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2016 | ||||||||
| LastUpdateDate: | 10/06/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | MT.0017282 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
No ID Information.