Provider Demographics
NPI:1972191286
Name:RED APEN HERBS & ACUPUNCTURE
Entity Type:Organization
Organization Name:RED APEN HERBS & ACUPUNCTURE
Other - Org Name:RED APSEN WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEWALD
Authorized Official - Suffix:
Authorized Official - Credentials:DACM, LAC
Authorized Official - Phone:303-819-1518
Mailing Address - Street 1:2955 VALMONT RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1360
Mailing Address - Country:US
Mailing Address - Phone:303-819-1518
Mailing Address - Fax:
Practice Address - Street 1:2955 VALMONT RD STE 100
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1360
Practice Address - Country:US
Practice Address - Phone:303-819-1518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty