Healthcare Provider Details

I. General information

NPI: 1730365982
Provider Name (Legal Business Name): BRIAN C. MEARS L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 W SOUTH BOULDER RD STE 5
LOUISVILLE CO
80027-1160
US

IV. Provider business mailing address

13207 HOLLY ST UNIT F
THORNTON CO
80241-3183
US

V. Phone/Fax

Practice location:
  • Phone: 303-929-7334
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU-1346
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: