Provider Demographics
NPI:1992294540
Name:STILES, VERONICA LYNN
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:LYNN
Last Name:STILES
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 1:1554 H38 RD
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-3328
Mailing Address - Country:US
Mailing Address - Phone:970-985-1491
Mailing Address - Fax:
Practice Address - Street 1:1554 H38 RD
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-3328
Practice Address - Country:US
Practice Address - Phone:970-985-1491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0012289225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist