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General NPI Number Information
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NPI Number | 1376824250
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Entity Type | Individual
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Provider Name | CASEY REIN LAC
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Gender | Male
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 7601 SOUTH UNIVERSITY BLVD SUITE 103
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City | CENTENNIAL
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State | CO
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Zip | 80122
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Country | US
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Telephone | 303-730-3177
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Fax |
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Provider Business Mailing Address
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Address Line | 9814 GATESBURY CIR
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80126-6839
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Country | US
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Telephone | 303-503-0403
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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 | 1398
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License Number State | CO
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