Provider Demographics
NPI:1447825542
Name:SHILOAH HOWARD LICENSED ACUPUNCTURIST
Entity type:Organization
Organization Name:SHILOAH HOWARD LICENSED ACUPUNCTURIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:SHILOAH
Authorized Official - Middle Name:GERMAIN
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:720-202-1100
Mailing Address - Street 1:325 BROPHY CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:CO
Mailing Address - Zip Code:80530-8056
Mailing Address - Country:US
Mailing Address - Phone:720-202-1100
Mailing Address - Fax:720-750-7807
Practice Address - Street 1:426 5TH STREET
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:CO
Practice Address - Zip Code:80530
Practice Address - Country:US
Practice Address - Phone:720-750-7807
Practice Address - Fax:720-750-7807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1952838807OtherACUPUNCTURE