Provider Demographics
NPI:1093130460
Name:DROUILLARD, BRANDON (LAC, DIPLAC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:DROUILLARD
Suffix:
Gender:M
Credentials:LAC, DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 IRIS WAY
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-5159
Mailing Address - Country:US
Mailing Address - Phone:720-317-6847
Mailing Address - Fax:
Practice Address - Street 1:4424 W 29TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-3015
Practice Address - Country:US
Practice Address - Phone:720-317-6847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-21
Last Update Date:2019-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1334171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist