MEDICARE: YEVGENY KOKORIN L.AC

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	1388	CO

General Provider Information

NPI Number	:	1659546075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YEVGENY KOKORIN L.AC

Provider Business Mailing Address
First Line	:	88 INVERNESS CIR E
Second Line	:	BLD F-103
City	:	ENGLEWOOD
State	:	CO
Zip	:	80112-5304
Country	:	US
Telephone Number	:	720-299-8278
Fax Number	:

Provider Business Practice Location Address
First Line	:	88 INVERNESS CIR E
Second Line	:	BLD F-103
City	:	ENGLEWOOD
State	:	CO
Zip	:	80112-5304
Country	:	US
Telephone Number	:	720-299-8278
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2008
Last Update Date	:	04/26/2008

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