Provider Demographics
NPI:1124657994
Name:SPINELLI-BUSER, VIRGINIA EILEEN
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:EILEEN
Last Name:SPINELLI-BUSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1544 OXBOW DR STE 140
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5189
Mailing Address - Country:US
Mailing Address - Phone:970-596-9989
Mailing Address - Fax:
Practice Address - Street 1:1544 OXBOW DR STE 140
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5189
Practice Address - Country:US
Practice Address - Phone:970-596-9989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11489225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist