Provider Demographics
NPI:1447524517
Name:AU COURANT MASSAGE INC.
Entity type:Organization
Organization Name:AU COURANT MASSAGE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARCHELLA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:720-309-7904
Mailing Address - Street 1:790 CLERMONT ST
Mailing Address - Street 2:7
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-5000
Mailing Address - Country:US
Mailing Address - Phone:720-309-7904
Mailing Address - Fax:
Practice Address - Street 1:910 SANTA FE DR
Practice Address - Street 2:19
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3975
Practice Address - Country:US
Practice Address - Phone:720-309-7904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT-7386225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty