Jason Christopher Moore, LMT
Massage Therapist in Paonia, CO. Individual provider (NPI-1).
NPI number1114689502
StatusActive
Last updated in NPPESOct 12, 2021
Details
- NPI
- 1114689502
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jason Christopher Moore
- Credential
- LMT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 12, 2021
- Certification date
- Oct 12, 2021
- Last updated
- Oct 12, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 24361 | CO | Yes |
Practice location
41050 Lamborn Mesa RdPaonia, CO 81428-6433
Phone 267-670-9535
Mailing address
41050 Lamborn Mesa RdPaonia, CO 81428-6433
Phone 267-670-9535
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