Healthcare Provider Details

I. General information

NPI: 1144529124
Provider Name (Legal Business Name): EAST WEST HEALTH PROFESSIONALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 03/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 S CLARKSON ST SUITE 100
ENGLEWOOD CO
80113-3909
US

IV. Provider business mailing address

3555 S CLARKSON ST SUITE 100
ENGLEWOOD CO
80113-3909
US

V. Phone/Fax

Practice location:
  • Phone: 303-789-2330
  • Fax: 303-927-6616
Mailing address:
  • Phone: 303-789-2330
  • Fax: 303-927-6616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. TAMARA POLLACK
Title or Position: ACUPUNCTURIST/BUSINESS OWNER
Credential:
Phone: 303-789-2330