MEDICARE: HEALING ART MEDICAL CENTER LLC

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
1	171100000X	Acupuncturist	1218	CO

General Provider Information

NPI Number	:	1386972032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING ART MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	2004 TRENT AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909
Country	:	US
Telephone Number	:	719-466-1710
Fax Number	:

Provider Business Practice Location Address
First Line	:	2004 TRENT AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909
Country	:	US
Telephone Number	:	719-466-1710
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ MANAGER
Name	:	MR. VALENTIN MIREA
Credential	:	L. AC.
Telephone Number	:	719-466-1710

Provider Enumeration Date	:	11/18/2009
Last Update Date	:	08/03/2010

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