Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 2504 | CO |
NPI | 1427317551 |
---|---|
Provider Name | Ms. Fengqin Lu |
First Address | Littleton, CO 80128-4566 |
Second Address | Littleton, CO 80128-4566 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2012 |
Last Update Date | 09/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
946546 | AMERICAN SPECIALTY HEALTH MASSAGE THERAPY NETWORK (01) | CA |