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General NPI Number Information
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NPI Number | 1972711059
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Entity Type | Organization
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Legal Business Name | HEALTHY LIVES ACUPUNCTURE LLC
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Dates
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Enumeration Date | 05/20/2007
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Last Update Date | 12/20/2010
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Provider Practice Location Address
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Address Line | 3333 S WADSWORTH BLVD BLDG D
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City | LAKEWOOD
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State | CO
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Zip | 80227-5122
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Country | US
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Telephone | 303-922-0079
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 S WADSWORTH BLVD BLDG D PO BOX 1
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City | LAKEWOOD
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State | CO
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Zip | 80227-5122
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Country | US
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Telephone | 303-922-0079
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MARCUS AARON RHODEN
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Credential |
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Telephone | 303-922-0079
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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 | 11675
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 1296
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License Number State | CO
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