MEDICARE: PRISCILLA ALLEN LIC. 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	856	CO

General Provider Information

NPI Number	:	1588074892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA ALLEN LIC. AC.

Provider Business Mailing Address
First Line	:	6444 S QUEBEC ST
Second Line	:	7-202
City	:	CENTENNIAL
State	:	CO
Zip	:	80111-7601
Country	:	US
Telephone Number	:	303-221-0644
Fax Number	:

Provider Business Practice Location Address
First Line	:	6444 S QUEBEC ST
Second Line	:	7-202
City	:	CENTENNIAL
State	:	CO
Zip	:	80111-7601
Country	:	US
Telephone Number	:	303-221-0644
Fax Number	:

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

Provider Enumeration Date	:	05/08/2014
Last Update Date	:	05/08/2014

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