BLACKHAWK ACUPUNCTURE AND HERBAL HEALING CENTER LLC (NPI# 1417489519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417489519 |
| Entity Type | Organization |
| Organization Name | BLACKHAWK ACUPUNCTURE AND HERBAL HEALING CENTER LLC |
| Other Organization Name | PUEBLO HOLISTIC WELLNESS CENTER |
| Practice Address |
1307 Fortino Blvd Ste C Pueblo CO 81008-2032 |
| Mailing Address |
Po Box 296 Beulah CO 81023-0296 |
| Practice Telephone | 7195821010 |
| Practice Fax Number | 7196317012 |
| Mailing Telephone | 7193965375 |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2020-08-21 |
| Authorized Official Name | TRACEY RENEE WALKER (MANAGING MEMBER) |
| Authorized Official Telephone | 7193965375 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171100000X | Acupuncturist | ACU.0001916 | CO | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Pueblo Holistic Wellness Center | Doing Business As Name - Organization |
| Street Address |
1307 FORTINO BLVD STE C |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-2032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| Taxonomy Code | 171100000X |
| Grouping | Other Service Providers |
| Classification | Acupuncturist |
| An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720590615 | Tracey Renee Walker | Acupuncturist | 1303 Fortino Blvd Ste C, Pueblo, CO 81008-2032 | 2017-10-31 |
| 1467720201 | Susan Renee Phelps | Acupuncturist | 2099 Highway 50 West, Suite 130 G, Pueblo, CO 81008 | 2011-12-08 |
| 1326218108 | Zach James Gray | Acupuncturist | 3312 Colfax Ave., Pueblo, CO 81008 | 2008-03-07 |
| 1881810612 | Troy E. Sammons | Acupuncturist | 115 W 11th St, Pueblo, CO 81003-2801 | 2007-04-18 |
| 1528181054 | Susan D. Kimpton | Acupuncturist | 226 W Abriendo Ave, Suite B., Pueblo, CO 81004-1868 | 2007-04-09 |
| 1396874566 | Turner Ray | Acupuncturist | 627 Van Buren St, Pueblo, CO 81004-1860 | 2007-03-05 |
| 1427199728 | Donald Skonieczka | Acupuncturist | 251 S Santa Fe, Pueblo, CO 81003 | 2007-02-09 |
| 1306860606 | Tawnya M Salas | Acupuncturist | 126 West D Street, Suite 100c, Pueblo, CO 81003 | 2006-07-27 |
| 1265988398 | Kelly Marie Hill | Acupuncturist | 111 W Evans Ave, Pueblo, CO 81004-4215 | 2016-08-29 |
| 1932467073 | Lorax Inc. | Acupuncturist | 115 W 11th St, Pueblo, CO 81003-2801 | 2012-04-26 |
| Find all providers in PUEBLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.