Provider Demographics
NPI:1174897342
Name:JARAMILLO, LAURA CATHERINE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:CATHERINE
Last Name:JARAMILLO
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:CATHERINE
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MASSAGE THERAPIST
Mailing Address - Street 1:1120 38TH AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2578
Mailing Address - Country:US
Mailing Address - Phone:970-310-9474
Mailing Address - Fax:
Practice Address - Street 1:1120 38TH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2578
Practice Address - Country:US
Practice Address - Phone:970-310-9474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5130225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist