Provider Demographics
NPI:1205381308
Name:FIVE ELEMENT ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:FIVE ELEMENT ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSCIO
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:303-791-0582
Mailing Address - Street 1:9072 KENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-3409
Mailing Address - Country:US
Mailing Address - Phone:303-791-0582
Mailing Address - Fax:
Practice Address - Street 1:9072 KENWOOD CT
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-3409
Practice Address - Country:US
Practice Address - Phone:303-791-0582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO851171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty