MEDICARE: DENISE ELLINGER 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	773	CO

General Provider Information

NPI Number	:	1740321876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE ELLINGER L.AC.

Provider Business Mailing Address
First Line	:	1777 S BELLAIRE ST
Second Line	:	SUITE 102
City	:	DENVER
State	:	CO
Zip	:	80222-4306
Country	:	US
Telephone Number	:	303-377-3201
Fax Number	:	303-757-0505

Provider Business Practice Location Address
First Line	:	1777 S BELLAIRE ST
Second Line	:	SUITE 102
City	:	DENVER
State	:	CO
Zip	:	80222-4306
Country	:	US
Telephone Number	:	303-377-3201
Fax Number	:	303-757-0505

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

Provider Enumeration Date	:	02/10/2007
Last Update Date	:	07/08/2007

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