Healthcare Provider Details

I. General information

NPI: 1962742221
Provider Name (Legal Business Name): JARET SAHR L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2013
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5261 N PORT WASHINGTON RD A
GLENDALE WI
53217-4903
US

IV. Provider business mailing address

9730 W BLUEMOUND RD STE 12
WAUWATOSA WI
53226-4455
US

V. Phone/Fax

Practice location:
  • Phone: 414-332-6001
  • Fax: 414-332-3712
Mailing address:
  • Phone: 414-640-7247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number381-55
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: