Healthcare Provider Details

I. General information

NPI: 1710315767
Provider Name (Legal Business Name): DENVER FAMILY ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 E SPEER BLVD SUITE 217
DENVER CO
80218-3719
US

IV. Provider business mailing address

825 E SPEER BLVD SUITE 217
DENVER CO
80218-3719
US

V. Phone/Fax

Practice location:
  • Phone: 720-334-8544
  • Fax: 720-917-1000
Mailing address:
  • Phone: 720-334-8544
  • Fax: 720-917-1000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1655
License Number StateCO

VIII. Authorized Official

Name: HAYDEN HENNINGSEN
Title or Position: OWNER
Credential: LAC
Phone: 720-334-8544