Healthcare Provider Details

I. General information

NPI: 1073459053
Provider Name (Legal Business Name): LAINEE REESE HAUER LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 29TH ST STE 101B
GREELEY CO
80634-8386
US

IV. Provider business mailing address

6500 W 29TH ST STE 101B
GREELEY CO
80634
US

V. Phone/Fax

Practice location:
  • Phone: 970-373-9028
  • Fax:
Mailing address:
  • Phone: 970-373-9028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0002995
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: