Provider Demographics
NPI:1447941356
Name:HALL, IANN (LAC)
Entity type:Individual
Prefix:
First Name:IANN
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6469 W COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-1801
Mailing Address - Country:US
Mailing Address - Phone:720-420-9659
Mailing Address - Fax:303-379-4150
Practice Address - Street 1:6469 W COLFAX AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-1801
Practice Address - Country:US
Practice Address - Phone:720-420-9659
Practice Address - Fax:303-379-4150
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002030171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist