Provider Demographics
NPI:1932308921
Name:CORTEZ FAMILY ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:CORTEZ FAMILY ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HAWES
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:970-565-0230
Mailing Address - Street 1:PO BOX 681
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-0681
Mailing Address - Country:US
Mailing Address - Phone:970-565-0230
Mailing Address - Fax:970-565-3463
Practice Address - Street 1:1 W 1ST ST
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-3507
Practice Address - Country:US
Practice Address - Phone:970-565-0230
Practice Address - Fax:970-565-3463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO897171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty