Provider Demographics
NPI:1497191498
Name:ACUPUNCTURE LIFEOLOGY, INC
Entity Type:Organization
Organization Name:ACUPUNCTURE LIFEOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:Q
Authorized Official - Last Name:DONG
Authorized Official - Suffix:
Authorized Official - Credentials:L AC, CMD
Authorized Official - Phone:303-949-8428
Mailing Address - Street 1:1325 S COLORADO BLVD
Mailing Address - Street 2:B-012
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3303
Mailing Address - Country:US
Mailing Address - Phone:303-949-8428
Mailing Address - Fax:
Practice Address - Street 1:1325 S COLORADO BLVD
Practice Address - Street 2:SUITE B-012
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3303
Practice Address - Country:US
Practice Address - Phone:303-949-8428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO566261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO 566OtherACUPUNCTURE, HERBAL MEDICINE