Healthcare Provider Details

I. General information

NPI: 1952562506
Provider Name (Legal Business Name): NATURAL RESOURCES INTEGRATED HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2760 29TH ST SUITE 2E
BOULDER CO
80301-1214
US

IV. Provider business mailing address

2760 29TH ST SUITE 2E
BOULDER CO
80301-1214
US

V. Phone/Fax

Practice location:
  • Phone: 303-541-9600
  • Fax: 303-938-9402
Mailing address:
  • Phone: 303-541-9600
  • Fax: 303-938-9402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number669
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number61
License Number StateMT

VIII. Authorized Official

Name: DR. JANINE L. MALCOLM
Title or Position: PRESIDENT
Credential: ND, LAC
Phone: 303-541-9600