Provider Demographics
NPI:1689301871
Name:THE ROOT ACUPUNCTURE, LLC
Entity Type:Organization
Organization Name:THE ROOT ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:303-500-5075
Mailing Address - Street 1:13701 W JEWELL AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-4173
Mailing Address - Country:US
Mailing Address - Phone:303-500-5075
Mailing Address - Fax:720-710-1393
Practice Address - Street 1:13701 W JEWELL AVE STE 204
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-4173
Practice Address - Country:US
Practice Address - Phone:303-500-5075
Practice Address - Fax:720-710-1393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-06
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty