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General NPI Number Information
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NPI Number | 1619685229
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Entity Type | Organization
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Legal Business Name | ELEMENTAL HEALING LLC
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 11/11/2022
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Provider Practice Location Address
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Address Line | 3950 MIDLAND AVE STE 3
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-4605
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Country | US
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Telephone | 970-618-1537
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Fax | 970-930-6150
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Provider Business Mailing Address
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Address Line | 3950 MIDLAND AVE STE 3
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-4605
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Country | US
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Telephone | 970-618-1537
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Fax | 970-930-6150
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Authorized Official
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Title or Position | OWNER/ACUPUNCTURIST
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Name | CHRISTOPHER FABIJANIC
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Credential |
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Telephone | 970-618-1537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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