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NPI Code Detail

MEDICARE: MRS. KATE MARIE KELLOGG L.AC.

MEDICARE:  MRS. KATE MARIE KELLOGG  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
1171100000XAcupuncturist1264CO

General Provider Information

NPI Number : 1629385414
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATE MARIE KELLOGG L.AC.
Provider Business Mailing Address
First Line : 2416 W 32ND AVE
Second Line :
City : DENVER
State : CO
Zip : 80211-3322
Country : US
Telephone Number : 303-257-9102
Fax Number :
Provider Business Practice Location Address
First Line : 2416 W 32ND AVE
Second Line :
City : DENVER
State : CO
Zip : 80211-3322
Country : US
Telephone Number : 303-257-9102
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2010
Last Update Date : 09/01/2010

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Directions to “ MRS. KATE MARIE KELLOGG L.AC.” Practice Location

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