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Organization

MILLENNIUM WELLNESS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTIE M. LAVALLEY L.AC. (ACUPUNCTURIST)
(970) 856-4729
Entity
Organization

Contact information

Practice address
190 N GRAND MESA DR, CEDAREDGE, CO 81413-8388
(970) 856-4729
(970) 856-4734
Mailing address
190 N GRAND MESA DR, CEDAREDGE, CO 81413-8388
(970) 856-4729
(970) 856-4734

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
1293
CO
261QP3300X
Pain Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1760637508
PERSONAL NPI
CO
Enumeration date
10/05/2009
Last updated
10/05/2009
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