Provider Demographics
NPI:1659821163
Name:MUNCY, VONDA (LAC)
Entity Type:Individual
Prefix:
First Name:VONDA
Middle Name:
Last Name:MUNCY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:558 E CASTLE PINES PKWY # B4-312
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-4608
Mailing Address - Country:US
Mailing Address - Phone:720-772-7588
Mailing Address - Fax:720-340-5527
Practice Address - Street 1:850 W HAPPY CANYON RD
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-3908
Practice Address - Country:US
Practice Address - Phone:720-772-7588
Practice Address - Fax:720-340-5527
Is Sole Proprietor?:No
Enumeration Date:2016-10-07
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO2236171100000X
COACU.0002236171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist