Provider Demographics
NPI:1952935009
Name:EAST WINDS ACUPUNCTURE
Entity type:Organization
Organization Name:EAST WINDS ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:K
Authorized Official - Last Name:CRIDENNDA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:719-520-5056
Mailing Address - Street 1:1422 N HANCOCK AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2641
Mailing Address - Country:US
Mailing Address - Phone:719-520-5056
Mailing Address - Fax:719-520-5222
Practice Address - Street 1:1422 N HANCOCK AVE STE 5
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2641
Practice Address - Country:US
Practice Address - Phone:719-520-5056
Practice Address - Fax:719-520-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty