MEDICARE: FAMILY TREE ACUPUNCTURE & WELLNESS, 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
1	171100000X	Acupuncturist	ACU.0002107	CO

General Provider Information

NPI Number	:	1871952606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY TREE ACUPUNCTURE & WELLNESS, LLC

Provider Business Mailing Address
First Line	:	7955 E ARAPAHOE CT
Second Line	:	SUITE 1050
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-1358
Country	:	US
Telephone Number	:	720-507-1705
Fax Number	:

Provider Business Practice Location Address
First Line	:	7955 E ARAPAHOE CT
Second Line	:	SUITE 1050
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-1358
Country	:	US
Telephone Number	:	720-507-1705
Fax Number	:

Authorized Official
Title or Position	:	OWNER, PRACTITIONER
Name	:	JENNIFER GLASIER LUTHER
Credential	:	L.AC
Telephone Number	:	720-507-1705

Provider Enumeration Date	:	02/22/2016
Last Update Date	:	02/22/2016

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