MEDICARE: LOVELAND ACUPUNCTURE

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	1619	CO

General Provider Information

NPI Number	:	1942737382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVELAND ACUPUNCTURE

Provider Business Mailing Address
First Line	:	290 E 25TH ST
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-3211
Country	:	US
Telephone Number	:	970-599-1027
Fax Number	:

Provider Business Practice Location Address
First Line	:	290 E 25TH ST
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-3211
Country	:	US
Telephone Number	:	970-599-1027
Fax Number	:

Authorized Official
Title or Position	:	LICENSED ACUPUNCTURIST
Name	:	JENNIFER BAO
Credential	:
Telephone Number	:	970-599-1027

Provider Enumeration Date	:	05/16/2017
Last Update Date	:	05/16/2017

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Directions to “LOVELAND ACUPUNCTURE ” Practice Location

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