MEDICARE: THE SPOT, ACUPUNCTURE 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1861279879	OTHER	CO	ACUPUNCTURE

General Provider Information

NPI Number	:	1558141903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE SPOT, ACUPUNCTURE LLC

Provider Business Mailing Address
First Line	:	2332 CENTRAL PARK BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80238-3234
Country	:	US
Telephone Number	:	720-251-3989
Fax Number	:

Provider Business Practice Location Address
First Line	:	2332 CENTRAL PARK BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80238-3234
Country	:	US
Telephone Number	:	720-251-3989
Fax Number	:

Authorized Official
Title or Position	:	OWNER, ACUPUNCTURIST
Name	:	MICHAEL CORINE FUENTES-DANCHIK
Credential	:	L.AC
Telephone Number	:	720-251-3989

Provider Enumeration Date	:	10/03/2023
Last Update Date	:	10/03/2023

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Directions to “THE SPOT, ACUPUNCTURE LLC ” Practice Location

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