Justin McDonald, LMT, HBS, CFSC
Massage Therapist in Colorado Springs, CO. Individual provider (NPI-1).
NPI number1164031555
StatusActive
Last updated in NPPESJul 30, 2020
Details
- NPI
- 1164031555
- Entity type
- Individual (NPI-1)
- Name
- Justin McDonald
- Credential
- LMT, HBS, CFSC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 30, 2020
- Certification date
- Jul 30, 2020
- Last updated
- Jul 30, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | MT.0022782 | CO | Yes |
Practice location
4740 Flintridge Dr Ste 130Colorado Springs, CO 80918-4273
Phone 719-917-1000
Mailing address
3028 Deliverance DrColorado Springs, CO 80918-1675
Phone 815-540-1688
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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