Provider Demographics
NPI:1568709319
Name:GENSHEER, RICHELLE (LAC, DIPL OM)
Entity Type:Individual
Prefix:
First Name:RICHELLE
Middle Name:
Last Name:GENSHEER
Suffix:
Gender:F
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:RIKKI
Other - Middle Name:
Other - Last Name:GENSHEER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, DIPL OM
Mailing Address - Street 1:160 E 12TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5272
Mailing Address - Country:US
Mailing Address - Phone:970-749-4453
Mailing Address - Fax:
Practice Address - Street 1:160 E 12TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5272
Practice Address - Country:US
Practice Address - Phone:970-749-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1847171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist