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MRS. IRIS JEANETTE DIAZ CASSIDY CMT. COMT

>> Massage Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1598089518

Individual Registrant:
MRS. IRIS JEANETTE DIAZ CASSIDY CMT. COMT
Gender: F
Sole Proprietor

Location and contact information for practice:
1548 G STREET #8 LA PLACITA SALIDA, CO 81201 US
Tel: 719-207-1402  Fax: --

Contact information for business:
1548 G STREET #8 LA PLACITA SALIDA, CO 81201 US
Tel: 719-207-1402  Fax: --

Registration Information:
NPI: 1598089518
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist
CO3543

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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