Provider Demographics
NPI:1053688499
Name:DURGIN, MELISSA J (LAC, DIPL OM)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:J
Last Name:DURGIN
Suffix:
Gender:F
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4454 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-5731
Mailing Address - Country:US
Mailing Address - Phone:303-921-2993
Mailing Address - Fax:
Practice Address - Street 1:224 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-5111
Practice Address - Country:US
Practice Address - Phone:303-921-2993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU-1726171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist