Healthcare Provider Details

I. General information

NPI: 1306809785
Provider Name (Legal Business Name): SARAH EMILY WALTZMAN L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1936 S BROADWAY
DENVER CO
80210-4005
US

IV. Provider business mailing address

1936 S BROADWAY
DENVER CO
80210-4005
US

V. Phone/Fax

Practice location:
  • Phone: 303-777-2046
  • Fax: 303-777-2047
Mailing address:
  • Phone: 303-777-2046
  • Fax: 303-777-2047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number720
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: