Provider Demographics
NPI:1790866820
Name:HAMBLETON, ANN L (LAC)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:HAMBLETON
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:PO BOX 372
Mailing Address - Street 2:
Mailing Address - City:ELDORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80025-0372
Mailing Address - Country:US
Mailing Address - Phone:303-494-0409
Mailing Address - Fax:
Practice Address - Street 1:3447 ELDORADO SPRINGS DRIVE
Practice Address - Street 2:
Practice Address - City:ELDORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80025
Practice Address - Country:US
Practice Address - Phone:303-494-0409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO458171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist