Provider Demographics
NPI:1639715097
Name:HERB AND LEGEND ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:HERB AND LEGEND ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MELATI
Authorized Official - Middle Name:OLIVIA
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, LAC
Authorized Official - Phone:720-722-1447
Mailing Address - Street 1:1107 ELIZABETH ST APT 201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-3268
Mailing Address - Country:US
Mailing Address - Phone:720-351-0081
Mailing Address - Fax:
Practice Address - Street 1:1100 E EVANS AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-4548
Practice Address - Country:US
Practice Address - Phone:303-733-3387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty