Provider Demographics
NPI:1285128231
Name:VACCARI, DANIEL (LAC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:VACCARI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 WINDCHIME PL
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1984
Mailing Address - Country:US
Mailing Address - Phone:985-778-5430
Mailing Address - Fax:
Practice Address - Street 1:3314 MESA RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-1036
Practice Address - Country:US
Practice Address - Phone:719-520-4988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002823171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty