Provider Demographics
NPI:1346294410
Name:GREACEN, AMELIA FOX (LIC AC, DIPL AC, CH)
Entity Type:Individual
Prefix:MS
First Name:AMELIA
Middle Name:FOX
Last Name:GREACEN
Suffix:
Gender:F
Credentials:LIC AC, DIPL AC, CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 CONIFER CT
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1522
Mailing Address - Country:US
Mailing Address - Phone:303-546-0987
Mailing Address - Fax:303-447-0969
Practice Address - Street 1:3625 CONIFER CT
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1522
Practice Address - Country:US
Practice Address - Phone:303-546-0987
Practice Address - Fax:303-447-0969
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO113171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist