Provider Demographics
NPI:1306809785
Name:WALTZMAN, SARAH EMILY (LAC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:EMILY
Last Name:WALTZMAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-4005
Mailing Address - Country:US
Mailing Address - Phone:303-777-2046
Mailing Address - Fax:303-777-2047
Practice Address - Street 1:1936 S BROADWAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-4005
Practice Address - Country:US
Practice Address - Phone:303-777-2046
Practice Address - Fax:303-777-2047
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO720171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist