MEDICARE: MRS. KARI DIANE POLLERT L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	522	CO

General Provider Information

NPI Number	:	1265511232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARI DIANE POLLERT L.AC.

Provider Business Mailing Address
First Line	:	PO BOX 773869
Second Line	:
City	:	STEAMBOAT SPRINGS
State	:	CO
Zip	:	80477-3869
Country	:	US
Telephone Number	:	970-846-8985
Fax Number	:	970-879-4928

Provider Business Practice Location Address
First Line	:	1560 PINE GROVE ROAD
Second Line	:
City	:	STEAMBOAT SPRINGS
State	:	CO
Zip	:	80487
Country	:	US
Telephone Number	:	970-846-8985
Fax Number	:	970-879-4928

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	02/08/2013

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