Provider Demographics
NPI:1477291573
Name:SANELLI, BRITTANY (LAC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:SANELLI
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 1:633 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-6956
Mailing Address - Country:US
Mailing Address - Phone:303-868-5004
Mailing Address - Fax:
Practice Address - Street 1:317 W SOUTH BOULDER RD STE 5
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1160
Practice Address - Country:US
Practice Address - Phone:303-816-8286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002666171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist