Provider Demographics
NPI:1043502537
Name:ACKERMAN, TODD M (CMT, RMT, NMT)
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:M
Last Name:ACKERMAN
Suffix:
Gender:M
Credentials:CMT, RMT, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 BLUFF ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2166
Mailing Address - Country:US
Mailing Address - Phone:303-931-9285
Mailing Address - Fax:
Practice Address - Street 1:3014 BLUFF ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2166
Practice Address - Country:US
Practice Address - Phone:303-931-9285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2765225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist