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General NPI Number Information
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NPI Number | 1154963791
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Entity Type | Individual
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Provider Name | BECKY LYNN MANDERS L.AC
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Gender | Female
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 10/15/2019
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Provider Practice Location Address
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Address Line | 745 E 18TH AVE
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City | DENVER
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State | CO
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Zip | 80203-1414
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Country | US
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Telephone | 720-434-6106
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Fax |
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Provider Business Mailing Address
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Address Line | 18151 E ADRIATIC PL
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City | AURORA
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State | CO
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Zip | 80013-4213
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Country | US
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Telephone | 720-434-6106
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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 | 0002320
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License Number State | CO
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