Provider Demographics
NPI:1679149843
Name:MILE HIGH MEDICAL MASSAGE, LLC
Entity type:Organization
Organization Name:MILE HIGH MEDICAL MASSAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-306-2452
Mailing Address - Street 1:1390 S POTOMAC ST STE 128
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4529
Mailing Address - Country:US
Mailing Address - Phone:303-306-2408
Mailing Address - Fax:720-439-9527
Practice Address - Street 1:1390 S POTOMAC ST STE 128
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4529
Practice Address - Country:US
Practice Address - Phone:303-306-2408
Practice Address - Fax:720-439-9527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty