Provider Demographics
NPI:1851354054
Name:THAL, NANCY SUE (DIPL AC, LAC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:SUE
Last Name:THAL
Suffix:
Gender:F
Credentials:DIPL AC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-2052
Mailing Address - Country:US
Mailing Address - Phone:970-963-6702
Mailing Address - Fax:
Practice Address - Street 1:553 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-2052
Practice Address - Country:US
Practice Address - Phone:970-963-6702
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO553171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist