MEDICARE: ANDREA MICHELLE HARTMANN 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	565	CO

General Provider Information

NPI Number	:	1902844012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA MICHELLE HARTMANN L.AC

Provider Business Mailing Address
First Line	:	214 8TH ST
Second Line	:	SUITE 303
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-3326
Country	:	US
Telephone Number	:	970-945-2802
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 8TH ST
Second Line	:	SUITE 303
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-3326
Country	:	US
Telephone Number	:	970-945-2802
Fax Number	:

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	07/08/2007

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