Provider Demographics
NPI:1215157920
Name:MAGUIRE, JAMES J (DAC, LAC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:MAGUIRE
Suffix:
Gender:M
Credentials:DAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2853 FRONT ROYAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-4204
Mailing Address - Country:US
Mailing Address - Phone:719-332-4555
Mailing Address - Fax:
Practice Address - Street 1:2853 FRONT ROYAL DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919
Practice Address - Country:US
Practice Address - Phone:719-332-4555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP69171100000X
RIDA00015171100000X
CO508171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist