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General NPI Number Information
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NPI Number | 1124364856
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Entity Type | Organization
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Legal Business Name | GOLDSTONE ACUPUNCTURE & WHOLE HEALTH, LLC
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Dates
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Enumeration Date | 12/28/2012
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Last Update Date | 08/31/2013
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Provider Practice Location Address
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Address Line | 300 BOARDWALK DR BLDG 6A
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City | FORT COLLINS
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State | CO
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Zip | 80525-3070
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Country | US
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Telephone | 970-227-1906
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Fax |
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Provider Business Mailing Address
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Address Line | 300 BOARDWALK DR BLDG 6A
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City | FORT COLLINS
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State | CO
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Zip | 80525-3070
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Country | US
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Telephone | 970-227-1906
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN B GOLDSTONE
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Credential | L.AC, A.P, DIPL.AC
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Telephone | 970-227-1906
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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 | 1599
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License Number State | CO
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