Provider Demographics
NPI:1265864441
Name:SYDNEY COOLEY ACUPUNCTURE
Entity Type:Organization
Organization Name:SYDNEY COOLEY ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SYDNEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:970-426-8736
Mailing Address - Street 1:555 RIVERGATE LN SUITE B2-134
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7473
Mailing Address - Country:US
Mailing Address - Phone:970-426-8736
Mailing Address - Fax:970-764-4099
Practice Address - Street 1:555 RIVERGATE LN
Practice Address - Street 2:SUITE B2-134
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7473
Practice Address - Country:US
Practice Address - Phone:970-426-8736
Practice Address - Fax:970-764-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1161171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty