Provider Demographics
NPI:1447131602
Name:MACBETH, MICHAEL CRAIG (LMT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CRAIG
Last Name:MACBETH
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:MIKEAL
Other - Middle Name:
Other - Last Name:MACBETH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5803 MCWHINNEY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8829
Mailing Address - Country:US
Mailing Address - Phone:970-658-5184
Mailing Address - Fax:
Practice Address - Street 1:5803 MCWHINNEY BLVD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-8829
Practice Address - Country:US
Practice Address - Phone:970-658-5184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0017387225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist