MEDICARE: ACU & MASSAGE 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	664	CO

General Provider Information

NPI Number	:	1922233170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACU & MASSAGE WELLNESS, LLC

Provider Business Mailing Address
First Line	:	2231 S PLATTE RIVER DR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80223-4017
Country	:	US
Telephone Number	:	303-780-2840
Fax Number	:	303-922-9688

Provider Business Practice Location Address
First Line	:	2231 S PLATTE RIVER DR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80223-4017
Country	:	US
Telephone Number	:	303-780-2840
Fax Number	:	303-922-9688

Authorized Official
Title or Position	:	OWNER
Name	:	PAT WIGNER ISAACS
Credential	:
Telephone Number	:	303-780-2840

Provider Enumeration Date	:	05/18/2009
Last Update Date	:	05/18/2009

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