Provider Demographics
NPI:1154754174
Name:CENTER FOR INTEGRATED EASTERN MEDICINE
Entity type:Organization
Organization Name:CENTER FOR INTEGRATED EASTERN MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOT
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMES
Authorized Official - Suffix:
Authorized Official - Credentials:ACUPUNCTURIST
Authorized Official - Phone:303-810-9255
Mailing Address - Street 1:7283 ELLIS ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-3578
Mailing Address - Country:US
Mailing Address - Phone:303-810-9255
Mailing Address - Fax:720-362-5078
Practice Address - Street 1:1022 DEPOT HILL RD
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1068
Practice Address - Country:US
Practice Address - Phone:303-810-9255
Practice Address - Fax:720-362-5078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1213171100000X
CO1551171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty