Healthcare Provider Details

I. General information

NPI: 1215536198
Provider Name (Legal Business Name): BOULDER BODY BALANCE ACUPUNCTURE CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 FOLSOM ST
BOULDER CO
80304-2838
US

IV. Provider business mailing address

3004 FOLSOM ST
BOULDER CO
80304-2838
US

V. Phone/Fax

Practice location:
  • Phone: 720-509-9588
  • Fax:
Mailing address:
  • Phone: 720-509-9588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: ELIF KUZU
Title or Position: OWNER
Credential: DAOM
Phone: 720-509-9588