Healthcare Provider Details
I. General information
NPI: 1376882688
Provider Name (Legal Business Name): ACUPUNCTURE ACCESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2013
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5125 S COLLEGE AVE SUITE A
FORT COLLINS CO
80525-3959
US
IV. Provider business mailing address
5125 S COLLEGE AVE SUITE A
FORT COLLINS CO
80525-3959
US
V. Phone/Fax
- Phone: 970-484-0013
- Fax:
- Phone: 970-484-0013
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 1115 |
| License Number State | CO |
VIII. Authorized Official
Name: MS.
ABBYE
SILVERSTEIN
Title or Position: ACUPUNCTURIST
Credential: L.AC
Phone: 303-588-4663