Provider Demographics
NPI:1215234091
Name:LU, LI (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:LI
Middle Name:
Last Name:LU
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 KIPLING ST
Mailing Address - Street 2:SUITE G4
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-1580
Mailing Address - Country:US
Mailing Address - Phone:303-257-9607
Mailing Address - Fax:
Practice Address - Street 1:2201 KIPLING ST
Practice Address - Street 2:SUITE G4
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-1580
Practice Address - Country:US
Practice Address - Phone:303-257-9607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO486171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist