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NPI Code Detail

MEDICARE: MDK, LLC

MEDICARE: MDK, 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
1171100000XAcupuncturist1502CO

General Provider Information

NPI Number : 1265739775
Entity Type Code : Organization
Provider Name (Legal Business Name) : MDK, LLC
Provider Business Mailing Address
First Line : 3535 W 44TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80211-1313
Country : US
Telephone Number : 303-408-2990
Fax Number : 303-284-5639
Provider Business Practice Location Address
First Line : 3535 W 44TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80211-1313
Country : US
Telephone Number : 303-408-2990
Fax Number : 303-284-5639
Authorized Official
Title or Position : OWNER/PRACTITIONER
Name : MICHELE KINGSLEY
Credential : L.AC, DIPL O.M.
Telephone Number : 303-408-2990
Provider Enumeration Date : 02/17/2011
Last Update Date : 02/17/2011

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Directions to “MDK, LLC ” Practice Location

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