Provider Demographics
NPI:1346021417
Name:BILTHOUSE, TIFFANY NOELLE (LAC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:NOELLE
Last Name:BILTHOUSE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 MAIN ST
Mailing Address - Street 2:UNIT 311
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027
Mailing Address - Country:US
Mailing Address - Phone:630-642-0443
Mailing Address - Fax:
Practice Address - Street 1:2150 W 29TH AVE STE 320
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3889
Practice Address - Country:US
Practice Address - Phone:720-696-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002836171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist