Provider Demographics
NPI:1790976157
Name:STOEBNER, BRUCE ALAN (LAC)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:ALAN
Last Name:STOEBNER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 XANTHIA CT.
Mailing Address - Street 2:NEW DAY ACUPUNCTURE
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2655
Mailing Address - Country:US
Mailing Address - Phone:720-838-7918
Mailing Address - Fax:
Practice Address - Street 1:2840 XANTHIA CT
Practice Address - Street 2:NEW DAY ACUPUNCTURE
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-2655
Practice Address - Country:US
Practice Address - Phone:720-838-7918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO932171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist