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General NPI Number Information
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NPI Number | 1215246384
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Entity Type | Organization
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Legal Business Name | CRESTONE RESEARCH GROUP
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Dates
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Enumeration Date | 10/06/2010
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Last Update Date | 10/06/2010
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Provider Practice Location Address
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Address Line | 1331 VINE ST
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City | DENVER
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State | CO
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Zip | 80206-2011
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Country | US
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Telephone | 303-947-6224
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Fax |
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Provider Business Mailing Address
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Address Line | 1331 VINE ST
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City | DENVER
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State | CO
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Zip | 80206-2011
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Country | US
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Telephone | 303-947-6224
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | MARTHA LUCAS
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Credential | PH.D., L.AC.
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Telephone | 303-947-6224
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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 | 780
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License Number State | CO
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