Provider Demographics
NPI:1942737382
Name:LOVELAND ACUPUNCTURE
Entity Type:Organization
Organization Name:LOVELAND ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-599-1027
Mailing Address - Street 1:290 E 25TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-3211
Mailing Address - Country:US
Mailing Address - Phone:970-599-1027
Mailing Address - Fax:
Practice Address - Street 1:290 E 25TH ST
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3211
Practice Address - Country:US
Practice Address - Phone:970-599-1027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POLARIS HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-16
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1619171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty