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NPI 1295479079

NPI 1295479079 : SUZANNE G SPIEGEL LAC : LAFAYETTE, CO

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General NPI Number Information
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    NPI Number           |    1295479079
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    Entity Type          |    Individual 
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    Provider Name        |    SUZANNE G SPIEGEL LAC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/26/2022
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    Last Update Date     |    04/26/2022
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Provider Practice Location Address
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    Address Line         |    108 E BASELINE RD 
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    City                 |    LAFAYETTE
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    State                |    CO
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    Zip                  |    80026-2403
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    Country              |    US
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    Telephone            |    914-563-6080
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    708 E BASELINE RD 
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    City                 |    LAFAYETTE
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    State                |    CO
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    Zip                  |    80026-2453
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    Country              |    US
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    Telephone            |    914-563-6080
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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       |    0002728
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    License Number State |    CO
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