| First Line Acupuncture Llc | |
|
4800 Baseline Road C-108, Suite 114 Boulder CO 80303 | |
| (303) 956-3101 | |
| Not Available |
| Full Name | First Line Acupuncture Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4800 Baseline Road, Boulder, Colorado |
| Authorized Official Name and Position | Scott Erik Clemensen (OWNER) |
| Authorized Official Contact | 3038870988 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First Line Acupuncture Llc 1601 29th Street #1142 Suite 1292 Boulder CO 80301 Ph: (303) 956-3101 | First Line Acupuncture Llc 4800 Baseline Road C-108, Suite 114 Boulder CO 80303 Ph: (303) 956-3101 |
| NPI Number | 1780371278 |
|---|---|
| Provider Enumeration Date | 04/24/2023 |
| Last Update Date | 04/24/2023 |
| Medicare PECOS PAC ID | 6204292733 |
|---|---|
| Medicare Enrollment ID | O20230525001278 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780371278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Scott E Clemensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104932888 PECOS PAC ID: 9234185984 Enrollment ID: I20081229000624 |
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