Healthcare Provider Details

I. General information

NPI: 1629195730
Provider Name (Legal Business Name): ORIENTAL HEALING CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 09/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 W HWY 72
NEDERLAND CO
80466
US

IV. Provider business mailing address

PO BOX 4
NEDERLAND CO
80466-0004
US

V. Phone/Fax

Practice location:
  • Phone: 303-258-9112
  • Fax:
Mailing address:
  • Phone: 303-258-9112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1048
License Number StateCO

VIII. Authorized Official

Name: MRS. JUANITA ANN MCLAUGHLIN
Title or Position: ACUPUNCTURIST OWNER
Credential: LAC
Phone: 303-258-9112