Organization
MOUNTAIN VALLEY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOKO EVANS L.AC,MAOM, DIPL.OM (OWNER/ACUPUNCTURIST)
(970) 765-0727
Entity
Organization
Contact information
Practice address
326 MAIN ST, SUITE 200, DELTA, CO 81416-1869
(970) 765-0727
Mailing address
PO BOX 1152, MANCOS, CO 81328-1152
(970) 765-0727
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
0002134
CO
Other
Enumeration date
09/25/2015
Last updated
01/11/2017
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