Provider Demographics
NPI:1972711059
Name:HEALTHY LIVES ACUPUNCTURE LLC
Entity type:Organization
Organization Name:HEALTHY LIVES ACUPUNCTURE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:RHODEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-922-0079
Mailing Address - Street 1:3333 S WADSWORTH BLVD BLDG D
Mailing Address - Street 2:PO BOX 1
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5122
Mailing Address - Country:US
Mailing Address - Phone:303-922-0079
Mailing Address - Fax:
Practice Address - Street 1:3333 S WADSWORTH BLVD BLDG D
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5122
Practice Address - Country:US
Practice Address - Phone:303-922-0079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1296171100000X
CA11675171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty