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General NPI Number Information
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NPI Number | 1992195077
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Entity Type | Organization
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Legal Business Name | YOUNG'S ACUPUNCTURE CLINIC
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 3090 S JAMAICA CT SUITE # 113
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City | AURORA
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State | CO
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Zip | 80014-2658
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Country | US
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Telephone | 303-834-2080
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Fax |
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Provider Business Mailing Address
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Address Line | 6087 S QUATAR WAY
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City | AURORA
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State | CO
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Zip | 80015-5019
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Country | US
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Telephone | 303-562-4913
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MONICA YOUNG FERGUSON
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Credential | L.AC
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Telephone | 303-834-2080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ACU.0002059
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License Number State | CO
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