Healthcare Provider Details

I. General information

NPI: 1508937962
Provider Name (Legal Business Name): NA ZHAI L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W COLORADO AVE # B-204
COLORADO SPRINGS CO
80904-3882
US

IV. Provider business mailing address

5673 MARSHALL CREEK DR
COLORADO SPRINGS CO
80920-8104
US

V. Phone/Fax

Practice location:
  • Phone: 719-634-1669
  • Fax: 719-634-1961
Mailing address:
  • Phone: 719-282-3267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1028
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: