| Organization Name: | MILLENNIUM WELLNESS, LLC |
| NPI Number: | 1083949358 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTIE M. LAVALLEY (ACUPUNCTURIST) |
| Mailing Address: | 190 N Grand Mesa Dr Cedaredge |
| State: | CO US |
| Postal Code: | 814138388 |
| Phone Number: | 9708564729 |
| Fax Number: | 9708564734 |
| NPI Enumeration Date: | 10/05/2009 |
| NPI Last Update Date: | 10/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP3300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Pain |
| Taxonomy Definition: | |