Individual
MS. JODIE KIM MACTAVISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3096 I-70 BUSINESS LOOP, SUITE D, GRAND JUNCTION, CO 81504-5774
(970) 434-8500
(970) 434-8500
Mailing address
3096 I-70 BUSINESS LOOP, SUITE D, GRAND JUNCTION, CO 81504
(970) 434-8500
(970) 434-8500
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ELECTROACUPUNCTURE
CO
173C00000X
Reflexologist
N/A CERTIFICATION
CO
Other
Enumeration date
04/22/2011
Last updated
04/22/2011
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