Provider Demographics
NPI:1013514405
Name:LAKEWOOD COMMUNITY ACUPUCTURE
Entity Type:Organization
Organization Name:LAKEWOOD COMMUNITY ACUPUCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST, VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE-HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:720-242-9756
Mailing Address - Street 1:7114 W JEFFERSON AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235-2309
Mailing Address - Country:US
Mailing Address - Phone:720-242-9756
Mailing Address - Fax:
Practice Address - Street 1:7114 W JEFFERSON AVE STE 112
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2309
Practice Address - Country:US
Practice Address - Phone:720-242-9756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty