MEDICARE: FIERY SAGE HEALING, LLC.

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	1628	CO

General Provider Information

NPI Number	:	1225335789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIERY SAGE HEALING, LLC.

Provider Business Mailing Address
First Line	:	11220 ELM LN STE 200
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-0450
Country	:	US
Telephone Number	:	303-242-7443
Fax Number	:

Provider Business Practice Location Address
First Line	:	11220 ELM LN STE 200
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-0450
Country	:	US
Telephone Number	:	303-242-7443
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEN KING
Credential	:	L.AC
Telephone Number	:	910-444-1893

Provider Enumeration Date	:	02/18/2011
Last Update Date	:	02/09/2026

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