Provider Demographics
NPI:1194913236
Name:MEDICAL MASSAGE OF THE ROCKIES,LLC
Entity type:Organization
Organization Name:MEDICAL MASSAGE OF THE ROCKIES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:OGILVIE
Authorized Official - Suffix:
Authorized Official - Credentials:RN,CMT
Authorized Official - Phone:970-204-0516
Mailing Address - Street 1:3400 W 16TH ST
Mailing Address - Street 2:STE 6M
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-6862
Mailing Address - Country:US
Mailing Address - Phone:970-352-5716
Mailing Address - Fax:970-204-6812
Practice Address - Street 1:3400 W 16TH ST
Practice Address - Street 2:STE 6M
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-6862
Practice Address - Country:US
Practice Address - Phone:970-352-5716
Practice Address - Fax:970-204-6812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty