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General NPI Number Information
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NPI Number | 1689301871
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Entity Type | Organization
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Legal Business Name | THE ROOT ACUPUNCTURE, LLC
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Dates
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Enumeration Date | 08/06/2022
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Last Update Date | 08/06/2022
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Provider Practice Location Address
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Address Line | 13701 W JEWELL AVE STE 204
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City | LAKEWOOD
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State | CO
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Zip | 80228-4173
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Country | US
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Telephone | 303-500-5075
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Fax | 720-710-1393
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Provider Business Mailing Address
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Address Line | 13701 W JEWELL AVE STE 204
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City | LAKEWOOD
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State | CO
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Zip | 80228-4173
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Country | US
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Telephone | 303-500-5075
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Fax | 720-710-1393
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Authorized Official
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Title or Position | OWNER
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Name | ERIK JOHNSON
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Credential | L.AC.
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Telephone | 303-500-5075
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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 |
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License Number State |
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