Provider Demographics
NPI:1487885331
Name:POLLACK, JUSTIN B (ND)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:B
Last Name:POLLACK
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:507C MAIN ST.
Mailing Address - Street 2:PO BOX 4236
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443-4236
Mailing Address - Country:US
Mailing Address - Phone:970-668-1300
Mailing Address - Fax:970-668-1301
Practice Address - Street 1:507C MAIN ST.
Practice Address - Street 2:BOX 4236
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443-4236
Practice Address - Country:US
Practice Address - Phone:970-668-1300
Practice Address - Fax:970-668-1301
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1011175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath