Provider Demographics
NPI:1457601668
Name:CHARLES, JOSEPHINE GRACE (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:GRACE
Last Name:CHARLES
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1169 HILLTOP PKWY UNIT 206A
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-3176
Mailing Address - Country:US
Mailing Address - Phone:413-237-7049
Mailing Address - Fax:
Practice Address - Street 1:1169 HILLTOP PKWY UNIT 206A
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-3176
Practice Address - Country:US
Practice Address - Phone:970-761-2249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0001808171100000X
WANT 60320547175F00000X
KS21-00064175F00000X
UT11297538-7100175F00000X
COND.0000028175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist