Provider Demographics
NPI:1326363912
Name:SAUBERZWEIG, MICHELLE (LAC)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:SAUBERZWEIG
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 1:471 HIGHBANKS VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-9278
Mailing Address - Country:US
Mailing Address - Phone:303-909-0402
Mailing Address - Fax:
Practice Address - Street 1:471 HIGHBANKS VALLEY DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-9278
Practice Address - Country:US
Practice Address - Phone:303-909-0402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1569171100000X
117282171100000X
OH65. 000296171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1326363912OtherNPI NUMBER