MEDICARE: PAT WIGNER ISAACS L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	664	CO

General Provider Information

NPI Number	:	1144386517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAT WIGNER ISAACS L.AC.

Provider Business Mailing Address
First Line	:	2231 S PLATTE RIVER DR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80223-4017
Country	:	US
Telephone Number	:	303-780-2840
Fax Number	:

Provider Business Practice Location Address
First Line	:	2231 S PLATTE RIVER DR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80223-4017
Country	:	US
Telephone Number	:	303-780-2840
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	12/18/2007

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