Healthcare Provider Details

I. General information

NPI: 1306355979
Provider Name (Legal Business Name): RAINING SUN INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 FRONTIER AVE STE D
BOULDER CO
80301-2430
US

IV. Provider business mailing address

3550 FRONTIER AVE STE D
BOULDER CO
80301-2430
US

V. Phone/Fax

Practice location:
  • Phone: 720-989-1513
  • Fax:
Mailing address:
  • Phone: 720-989-1513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0002084
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0004550
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number0002084
License Number StateCO

VIII. Authorized Official

Name: SKY VAN HORN
Title or Position: OWNER
Credential: LAC, LMT, MOA
Phone: 720-989-1513