Most Relevant Information
Provider Data
| NPI Number: | 1003289158 |
| Provider Name: | BRENT HANEY LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | MT.0016804 |
Most Important Dates
| Enumeration Date: | 11/10/2015 |
| Last Updated: | 11/16/2021 |
Provider Practice Location
2457 LARK DR
COLORADO SPRINGS
CO
809091863
Practice Location Phone/Fax
| Phone: | 7192879184 |
| Fax: |
Provider Mailing Location
2457 LARK DR
COLORADO SPRINGS
CO
809091863
Provider Mailing Phone/Fax
| Phone: | 7192879184 |
| Fax: |