Provider Demographics
NPI:1003395179
Name:SPEARS, DONALD (ND, MSOM, LAC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:SPEARS
Suffix:
Gender:M
Credentials:ND, MSOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 BASELINE RD
Mailing Address - Street 2:#110
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303
Mailing Address - Country:US
Mailing Address - Phone:720-727-0188
Mailing Address - Fax:
Practice Address - Street 1:2995 BASELINE RD
Practice Address - Street 2:#110
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-8030
Practice Address - Country:US
Practice Address - Phone:720-727-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002537171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty