Provider Demographics
NPI:1558141903
Name:THE SPOT, ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:THE SPOT, ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CORINE
Authorized Official - Last Name:FUENTES-DANCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:720-251-3989
Mailing Address - Street 1:2332 CENTRAL PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-3234
Mailing Address - Country:US
Mailing Address - Phone:720-251-3989
Mailing Address - Fax:
Practice Address - Street 1:2332 CENTRAL PARK BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-3234
Practice Address - Country:US
Practice Address - Phone:720-251-3989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1861279879OtherACUPUNCTURE