Provider Demographics
NPI:1699586610
Name:ROJO, VIRIDIANA (LMT)
Entity type:Individual
Prefix:
First Name:VIRIDIANA
Middle Name:
Last Name:ROJO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1742 WILDWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LOCHBUIE
Mailing Address - State:CO
Mailing Address - Zip Code:80603-5812
Mailing Address - Country:US
Mailing Address - Phone:303-588-0057
Mailing Address - Fax:
Practice Address - Street 1:203 TELLURIDE ST UNIT 1000
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4367
Practice Address - Country:US
Practice Address - Phone:303-588-0057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0023748225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist