Organization
LIFECYCLE ACUPUNCTURE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA DONNA EATON LA.C (OWNER ACUPUNCTURIST)
(303) 656-0048
Entity
Organization
Contact information
Practice address
925 37TH ST, BOULDER, CO 80303-2141
(303) 656-0048
Mailing address
925 37TH ST, BOULDER, CO 80303-2141
(303) 656-0048
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
1761
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12471245
CAQH #
CO
Enumeration date
11/19/2013
Last updated
11/19/2013
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