Provider Demographics
NPI:1801152871
Name:RANDI SAVAGE CLASSICAL FIVE ELEMENT ACUPUNCTURE
Entity type:Organization
Organization Name:RANDI SAVAGE CLASSICAL FIVE ELEMENT ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS, LIC ACUPUNC
Authorized Official - Phone:303-710-9849
Mailing Address - Street 1:1830 SOUTHARD ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-7502
Mailing Address - Country:US
Mailing Address - Phone:303-710-9849
Mailing Address - Fax:775-490-9849
Practice Address - Street 1:1830 SOUTHARD ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-7502
Practice Address - Country:US
Practice Address - Phone:303-710-9849
Practice Address - Fax:775-490-9849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1291171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty