Provider Demographics
NPI:1447675731
Name:RUSCIO, JAN K (LAC)
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:K
Last Name:RUSCIO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9072 KENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-3409
Mailing Address - Country:US
Mailing Address - Phone:303-791-0582
Mailing Address - Fax:
Practice Address - Street 1:9072 KENWOOD CT
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-3409
Practice Address - Country:US
Practice Address - Phone:303-791-0582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO851171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist