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General NPI Number Information
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NPI Number | 1487958658
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Entity Type | Organization
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Legal Business Name | BEAUTY AND WELLNESS ACUPUNCTURE
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 01/03/2011
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Provider Practice Location Address
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Address Line | 6225 MISTY WAY
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City | NIWOT
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State | CO
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Zip | 80503-8895
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Country | US
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Telephone | 303-499-3247
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Fax |
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Provider Business Mailing Address
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Address Line | 6225 MISTY WAY
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City | NIWOT
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State | CO
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Zip | 80503-8895
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Country | US
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Telephone | 303-499-3247
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VALERIE CANNISTRARO
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Credential | L.AC., DIPL. OM
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Telephone | 303-618-1171
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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 | 1243
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License Number State | CO
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