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General NPI Number Information
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NPI Number | 1003299488
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Entity Type | Organization
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Legal Business Name | JOURNEY TOWARDS AWAKENING
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Dates
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Enumeration Date | 07/03/2015
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Last Update Date | 07/03/2015
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Provider Practice Location Address
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Address Line | 10090 GARRISON ST STE 101
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City | WESTMINSTER
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State | CO
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Zip | 80021-3894
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Country | US
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Telephone | 303-502-7570
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Fax |
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Provider Business Mailing Address
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Address Line | 3815 PASEO DEL PRADO
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City | BOULDER
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State | CO
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Zip | 80301-1521
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Country | US
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Telephone | 303-526-8642
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Fax |
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Authorized Official
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Title or Position | NATUROPATHIC DOCTOR
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Name | DR. JEAN MARIE BRISSON
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Credential | ND
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Telephone | 303-502-7570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1119
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 0000103
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License Number State | CO
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