Healthcare Provider Details

I. General information

NPI: 1205793106
Provider Name (Legal Business Name): CYNTHIA WALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E 9TH AVE UNIT 203
DENVER CO
80203-3360
US

IV. Provider business mailing address

700 E 9TH AVE UNIT 203
DENVER CO
80203-3360
US

V. Phone/Fax

Practice location:
  • Phone: 720-672-5136
  • Fax:
Mailing address:
  • Phone: 720-672-5136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: