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General NPI Number Information
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NPI Number | 1104671791
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Entity Type | Organization
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Legal Business Name | COUDRAY ACUPUNCTURE LLC
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Dates
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Enumeration Date | 04/18/2024
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 2900 E GRAND AVE UNIT 7
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City | LARAMIE
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State | WY
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Zip | 82070-5268
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Country | US
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Telephone | 321-303-5240
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Fax | 321-244-0453
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Provider Business Mailing Address
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Address Line | 2900 E GRAND AVE UNIT 7
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City | LARAMIE
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State | WY
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Zip | 82070-5268
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Country | US
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Telephone | 321-303-5240
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Fax | 321-244-0453
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Authorized Official
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Title or Position | PROVIDER
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Name | CATHERINE R COUDRAY
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Credential | AP DIPL AC
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Telephone | 321-303-5240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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