Provider Demographics
NPI:1649602178
Name:LACROIX, CHRISTINA (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:LACROIX
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 1:1816 S WHITCOMB ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1968
Mailing Address - Country:US
Mailing Address - Phone:303-585-0019
Mailing Address - Fax:
Practice Address - Street 1:1816 S WHITCOMB ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1968
Practice Address - Country:US
Practice Address - Phone:303-585-0019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU1373171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist