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NPI Code Detail

MEDICARE: MICHELE DIANE KINGSLEY L.AC.DIPL.O.M

MEDICARE: MICHELE DIANE KINGSLEY L.AC.DIPL.O.M
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
1171100000XAcupuncturist1502CO

General Provider Information

NPI Number : 1902138670
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE DIANE KINGSLEY L.AC.DIPL.O.M
Provider Business Mailing Address
First Line : 3535 W 44TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80211-1313
Country : US
Telephone Number : 303-408-2990
Fax Number :
Provider Business Practice Location Address
First Line : 3535 W 44TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80211-1313
Country : US
Telephone Number : 303-408-2990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2010
Last Update Date : 02/05/2010

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