Provider Demographics
NPI:1902844012
Name:HARTMANN, ANDREA MICHELLE (LAC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MICHELLE
Last Name:HARTMANN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:THE ACUPUNCTURE
Other - Middle Name:CLINIC OF ANDREA
Other - Last Name:HARTMANN, LAC.INC.
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:214 8TH ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-3326
Mailing Address - Country:US
Mailing Address - Phone:970-945-2802
Mailing Address - Fax:
Practice Address - Street 1:214 8TH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-3326
Practice Address - Country:US
Practice Address - Phone:970-945-2802
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO565171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist