Organization
ELEVATION ACUPUNCTURE & HERBS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA VIDAIC L.AC. (OWNER/ACUPUNCTURIST)
(303) 888-7895
Entity
Organization
Contact information
Practice address
3101 IRIS AVE, SUITE 200, BOULDER, CO 80301-1994
(303) 888-7895
Mailing address
655 W LOCUST CT, LOUISVILLE, CO 80027-1018
(303) 888-7895
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
1273
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871773150
INDIVIDUAL NPI
CO
Enumeration date
03/15/2011
Last updated
03/15/2011
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