Healthcare Provider Details

I. General information

NPI: 1770499238
Provider Name (Legal Business Name): AMETHYST ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5455 W 38TH AVE UNIT C
WHEAT RIDGE CO
80212-7068
US

IV. Provider business mailing address

1775 S BANNOCK ST APT 305
DENVER CO
80223-3630
US

V. Phone/Fax

Practice location:
  • Phone: 720-805-6247
  • Fax:
Mailing address:
  • Phone: 720-805-6247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MEGAN EDWARDS
Title or Position: ACUPUNCTURIST
Credential: LAC
Phone: 720-805-6247