Provider Demographics
NPI:1316496987
Name:ACUPUNCTURE CENTER OF NORTHERN COLORADO, LLC
Entity type:Organization
Organization Name:ACUPUNCTURE CENTER OF NORTHERN COLORADO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:F
Authorized Official - Last Name:RAMPONE-GULDER
Authorized Official - Suffix:
Authorized Official - Credentials:D AC
Authorized Official - Phone:970-493-0025
Mailing Address - Street 1:2550 STOVER STREET
Mailing Address - Street 2:BUILDING F
Mailing Address - City:FT. COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525
Mailing Address - Country:US
Mailing Address - Phone:970-493-0025
Mailing Address - Fax:970-232-2955
Practice Address - Street 1:2550 STOVER STREET
Practice Address - Street 2:BUILDING F
Practice Address - City:FT. COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525
Practice Address - Country:US
Practice Address - Phone:970-493-0025
Practice Address - Fax:970-232-2955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002209171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty