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General NPI Number Information
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NPI Number | 1124477443
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Entity Type | Individual
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Provider Name | HEATHER RICHMOND LA.C DAOM
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Gender | Female
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 09/17/2018
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Provider Practice Location Address
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Address Line | 908 MAIN ST STE B104
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City | LOUISVILLE
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State | CO
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Zip | 80027-1867
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Country | US
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Telephone | 303-444-4790
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Fax | 720-598-6121
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Provider Business Mailing Address
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Address Line | PO BOX 2112
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City | BOULDER
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State | CO
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Zip | 80306-2112
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Country | US
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Telephone | 303-444-4790
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0002080
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License Number State | CO
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