Healthcare Provider Details

I. General information

NPI: 1558688267
Provider Name (Legal Business Name): ACUPUNCTURE CHIROPRACTIC CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 04/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 21ST AVE
GREELEY CO
80631-6710
US

IV. Provider business mailing address

2116 21ST AVE
GREELEY CO
80631-6710
US

V. Phone/Fax

Practice location:
  • Phone: 970-330-2171
  • Fax: 970-339-2476
Mailing address:
  • Phone: 970-330-2171
  • Fax: 970-339-2476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4770
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number4770
License Number StateCO

VIII. Authorized Official

Name: MICHAEL JAMES SPRINGFIELD
Title or Position: OWNER/DOCTOR
Credential: D.C., DIPL.AC.
Phone: 970-330-2171