Healthcare Provider Details
I. General information
NPI: 1194972927
Provider Name (Legal Business Name): SYNERGY HEALTH AND WELLNESS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/22/2008
Last Update Date: 05/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 W LITTLETON BLVD STE 200
LITTLETON CO
80120-2239
US
IV. Provider business mailing address
1100 W LITTLETON BLVD STE 200
LITTLETON CO
80120-2239
US
V. Phone/Fax
- Phone: 303-471-1071
- Fax:
- Phone: 303-471-1071
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 173C00000X |
| Taxonomy | Reflexologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | CO |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133NN1002X |
| Taxonomy | Nutrition Education Nutritionist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
ERIKKA
M
KEEFER
Title or Position: OWNER
Credential: C.M.T., C.S.N.,C.P.
Phone: 303-471-1071