Provider Demographics
NPI:1356891121
Name:MORELAND, KAREN (LAC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MORELAND
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 1:2500 N CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1184
Mailing Address - Country:US
Mailing Address - Phone:719-434-8093
Mailing Address - Fax:719-445-0942
Practice Address - Street 1:2500 N CIRCLE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1184
Practice Address - Country:US
Practice Address - Phone:719-434-8093
Practice Address - Fax:719-445-0942
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002132171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist