Provider Demographics
NPI:1275243321
Name:LUMEN ACUPUNCTURE AND LIGHT LLC
Entity Type:Organization
Organization Name:LUMEN ACUPUNCTURE AND LIGHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-335-8554
Mailing Address - Street 1:651 COWEN DR
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-1592
Mailing Address - Country:US
Mailing Address - Phone:970-335-8554
Mailing Address - Fax:
Practice Address - Street 1:580 MAIN ST STE 300E
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-2072
Practice Address - Country:US
Practice Address - Phone:970-335-8554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty