Healthcare Provider Details

I. General information

NPI: 1073339990
Provider Name (Legal Business Name): KRYSTA KAUMP DACM, L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRYSTA KAUMP DACM, L.AC

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3989 E ARAPAHOE RD STE 120
CENTENNIAL CO
80122-2077
US

IV. Provider business mailing address

10013 ARMADILLO DR
LONE TREE CO
80124-9720
US

V. Phone/Fax

Practice location:
  • Phone: 303-740-2026
  • Fax:
Mailing address:
  • Phone: 303-941-4483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU.0002883
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: