Provider Demographics
NPI:1801927793
Name:DANN, JEFFREY (PHD, LAC)
Entity type:Individual
Prefix:PROF
First Name:JEFFREY
Middle Name:
Last Name:DANN
Suffix:
Gender:M
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 TABLE MESA DRIVE, STE. 205
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305
Mailing Address - Country:US
Mailing Address - Phone:303-499-9395
Mailing Address - Fax:
Practice Address - Street 1:3400 TABLE MESA DRIVE, STE. 205
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305
Practice Address - Country:US
Practice Address - Phone:303-499-9395
Practice Address - Fax:303-494-1492
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO260171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist