Provider Demographics
NPI:1104889039
Name:TRAVAGLIA, LORITA MAREE (L AC)
Entity type:Individual
Prefix:
First Name:LORITA
Middle Name:MAREE
Last Name:TRAVAGLIA
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1177 GRANT ST
Mailing Address - Street 2:100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2362
Mailing Address - Country:US
Mailing Address - Phone:720-220-7438
Mailing Address - Fax:303-861-4314
Practice Address - Street 1:1177 GRANT ST
Practice Address - Street 2:100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2362
Practice Address - Country:US
Practice Address - Phone:720-220-7438
Practice Address - Fax:303-861-4314
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO676171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist