Healthcare Provider Details

I. General information

NPI: 1841693447
Provider Name (Legal Business Name): ADAM HUTCHISON L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2014
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 MAIN ST STE 300E
CARBONDALE CO
81623-2072
US

IV. Provider business mailing address

651 COWEN DR
CARBONDALE CO
81623-1592
US

V. Phone/Fax

Practice location:
  • Phone: 970-335-8554
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU.0002021
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: