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General NPI Number Information
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NPI Number | 1487819041
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Entity Type | Individual
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Provider Name | ANGELA DAWN GAINER L.AC.
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Gender | Female
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 611 N NEVADA AVE SUITE 3
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-1099
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Country | US
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Telephone | 719-633-6313
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Fax | 719-447-9262
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Provider Business Mailing Address
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Address Line | 611 N NEVADA AVE SUITE 3
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-1099
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Country | US
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Telephone | 719-633-6313
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Fax | 719-447-9262
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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 | 411
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License Number State | CO
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