Provider Demographics
NPI:1316750003
Name:ROMERO, ROMAN MANUEL (LMT)
Entity type:Individual
Prefix:
First Name:ROMAN
Middle Name:MANUEL
Last Name:ROMERO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14672 E 22ND PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-2935
Mailing Address - Country:US
Mailing Address - Phone:303-596-7294
Mailing Address - Fax:
Practice Address - Street 1:14672 E 22ND PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-2935
Practice Address - Country:US
Practice Address - Phone:303-596-7294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0027195225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist