Organization
MOON RIVER CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA RUNDALL L.AC. (OWNER ACUPUNCTURIST)
(303) 803-4625
Entity
Organization
Contact information
Practice address
2150 W 29TH AVE STE 325, DENVER, CO 80211-3864
(303) 803-4625
Mailing address
3360 W 35TH AVE, DENVER, CO 80211-2706
(303) 803-4625
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
12/22/2022
Last updated
12/22/2022
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