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General NPI Number Information
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NPI Number | 1083866461
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Entity Type | Individual
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Provider Name | ELIZABETH TUCKER SAILER L.AC.
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Gender | Female
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 820 GRAVENSTEIN AVE SUITE 100
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City | SEBASTOPOL
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State | CA
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Zip | 95472-4557
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Country | US
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Telephone | 707-228-8102
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Fax |
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Provider Business Mailing Address
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Address Line | 7095 E HURLBUT AVE
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City | SEBASTOPOL
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State | CA
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Zip | 95472-2667
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Country | US
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Telephone | 707-228-8102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 5009
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License Number State | CA
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