Provider Demographics
NPI:1700186681
Name:SHAPIRO, ADAM C (LAC)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:C
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4730 TABLE MESA DR
Mailing Address - Street 2:SUITE K-100
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5560
Mailing Address - Country:US
Mailing Address - Phone:720-412-6200
Mailing Address - Fax:
Practice Address - Street 1:4730 TABLE MESA DR
Practice Address - Street 2:SUITE K-100
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5560
Practice Address - Country:US
Practice Address - Phone:720-412-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU-1617171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist