Provider Demographics
NPI:1801340591
Name:PEAK ONE ACUPUNCTURE
Entity type:Organization
Organization Name:PEAK ONE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUGE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DIPL OM, MTCM
Authorized Official - Phone:970-368-2068
Mailing Address - Street 1:PO BOX 293
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:CO
Mailing Address - Zip Code:80435-0293
Mailing Address - Country:US
Mailing Address - Phone:970-368-2068
Mailing Address - Fax:
Practice Address - Street 1:998 BLUE RIVER PKWY
Practice Address - Street 2:
Practice Address - City:SILVERTHORNE
Practice Address - State:CO
Practice Address - Zip Code:80498-9224
Practice Address - Country:US
Practice Address - Phone:970-368-2068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002213171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty