MEDICARE: SARAH DANIELSON N.D.

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	175F00000X	Naturopath	ND.0000112	CO

General Provider Information

NPI Number	:	1356702096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH DANIELSON N.D.

Provider Business Mailing Address
First Line	:	128 E LAS ANIMAS ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-4138
Country	:	US
Telephone Number	:	719-551-5282
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 E LAS ANIMAS ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-4138
Country	:	US
Telephone Number	:	719-551-5282
Fax Number	:

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

Provider Enumeration Date	:	03/08/2016
Last Update Date	:	03/08/2016

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