Provider Demographics
NPI:1598049967
Name:HEALING SOURCE ACUPUNCTURE
Entity Type:Organization
Organization Name:HEALING SOURCE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIPLOMATE ACUPUNCTURE
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MCELROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-329-4461
Mailing Address - Street 1:2220 S FRASER ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4508
Mailing Address - Country:US
Mailing Address - Phone:720-329-4461
Mailing Address - Fax:303-750-0579
Practice Address - Street 1:2220 S FRASER ST BUIDING1 UNIT 1
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013
Practice Address - Country:US
Practice Address - Phone:720-329-4461
Practice Address - Fax:303-750-0579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO580171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty