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NPI Code Detail

MEDICARE: WOVEN WISDOM

MEDICARE: WOVEN WISDOM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistACU.0001815CO

General Provider Information

NPI Number : 1174868558
Entity Type Code : Organization
Provider Name (Legal Business Name) : WOVEN WISDOM
Provider Business Mailing Address
First Line : 3628 MARIPOSA ST
Second Line :
City : DENVER
State : CO
Zip : 80211-3041
Country : US
Telephone Number : 720-440-2281
Fax Number :
Provider Business Practice Location Address
First Line : 3729 W 32ND AVE
Second Line :
City : DENVER
State : CO
Zip : 80211-3121
Country : US
Telephone Number : 720-440-2281
Fax Number :
Authorized Official
Title or Position : LICENSED ACUPUNCTURIST
Name : AMY LU BOOM
Credential : L.AC., DIPLOM
Telephone Number : 720-440-2281
Provider Enumeration Date : 12/11/2012
Last Update Date : 12/11/2012

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Directions to “WOVEN WISDOM ” Practice Location

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