Provider Demographics
NPI:1730473281
Name:STANLEY, EVA HYDINGER (DIPL AC)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:HYDINGER
Last Name:STANLEY
Suffix:
Gender:F
Credentials:DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3184 REDSTONE RD
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-7176
Mailing Address - Country:US
Mailing Address - Phone:303-902-3273
Mailing Address - Fax:
Practice Address - Street 1:1805 S BELLAIRE ST
Practice Address - Street 2:#101
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4305
Practice Address - Country:US
Practice Address - Phone:303-504-3600
Practice Address - Fax:303-504-3605
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO818171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist