Provider Demographics
NPI:1437519782
Name:INFINITE WELLNESS ACUPUNCTURE
Entity Type:Organization
Organization Name:INFINITE WELLNESS ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:970-930-1809
Mailing Address - Street 1:1317 GRAND AVE STE 228
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-3841
Mailing Address - Country:US
Mailing Address - Phone:970-930-1809
Mailing Address - Fax:970-945-4014
Practice Address - Street 1:1317 GRAND AVE STE 228
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-3841
Practice Address - Country:US
Practice Address - Phone:970-930-1809
Practice Address - Fax:970-945-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002181171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty