Provider Demographics
NPI:1609831866
Name:OSMUN, MELISSA ALICE (LAC)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:ALICE
Last Name:OSMUN
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 1:7173 E WARREN DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2530
Mailing Address - Country:US
Mailing Address - Phone:303-748-7971
Mailing Address - Fax:
Practice Address - Street 1:1600 CARR ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-5982
Practice Address - Country:US
Practice Address - Phone:303-748-7971
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO979171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist