MEDICARE: BROOKE ASHLEY WELLS-RECCHIA 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	0002812	CO

General Provider Information

NPI Number	:	1649047150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE ASHLEY WELLS-RECCHIA L.AC.

Provider Business Mailing Address
First Line	:	1108 COUNTRY ACRES DR
Second Line	:
City	:	JOHNSTOWN
State	:	CO
Zip	:	80534-8464
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1730 S COLLEGE AVE STE 301
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-1073
Country	:	US
Telephone Number	:	907-658-5777
Fax Number	:

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

Provider Enumeration Date	:	12/05/2023
Last Update Date	:	12/05/2023

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Directions to “ BROOKE ASHLEY WELLS-RECCHIA L.AC.” Practice Location

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