Provider Demographics
NPI:1609269091
Name:GRAVES, KASIA E (LAC, MSOM)
Entity type:Individual
Prefix:
First Name:KASIA
Middle Name:E
Last Name:GRAVES
Suffix:
Gender:F
Credentials:LAC, MSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:700 COLORADO BLVD # 697
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4084
Mailing Address - Country:US
Mailing Address - Phone:720-515-7339
Mailing Address - Fax:877-515-7339
Practice Address - Street 1:3500 E 17TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1813
Practice Address - Country:US
Practice Address - Phone:720-515-7339
Practice Address - Fax:877-515-7339
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-10
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU-1772171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist