Organization
MISTY MOUNTAIN MEDICINE
Active
Other names
Firehealer
Organization subpart
No
Provider details
NPI number
Authorized official
LACRETIA YVONNE BAJWA DOM (OWNER)
(505) 366-4033
Entity
Organization
Contact information
Practice address
3555 MERRIMENT WAY, COLORADO SPRINGS, CO 80917-2557
(505) 366-4033
Mailing address
PO BOX 26111, COLORADO SPRINGS, CO 80936-6111
(505) 366-4033
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1613
CO
171100000X
Acupuncturist
—
NM
Other
Enumeration date
02/21/2008
Last updated
10/25/2010
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