Provider Demographics
NPI:1821647678
Name:DORAK, MICHELLE (LAC, MSAC, DIPL AC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:DORAK
Suffix:
Gender:F
Credentials:LAC, MSAC, DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 COLORADO BLVD APT 332
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4088
Mailing Address - Country:US
Mailing Address - Phone:302-250-2091
Mailing Address - Fax:
Practice Address - Street 1:7625 W 5TH AVE STE 215D
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1453
Practice Address - Country:US
Practice Address - Phone:720-819-6715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist