Provider Demographics
NPI:1285865709
Name:FITCH, DAVID B (LAC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:FITCH
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:220 SUMMIT BLVD
Mailing Address - Street 2:APT. 214
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-8257
Mailing Address - Country:US
Mailing Address - Phone:720-201-2449
Mailing Address - Fax:303-665-9546
Practice Address - Street 1:1044 88TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027
Practice Address - Country:US
Practice Address - Phone:720-201-2449
Practice Address - Fax:303-665-9546
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO1493171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist