Provider Demographics
NPI:1043356579
Name:SCHMOTZER, BERNHARD (MS, DIPLOM, LAC)
Entity Type:Individual
Prefix:
First Name:BERNHARD
Middle Name:
Last Name:SCHMOTZER
Suffix:
Gender:M
Credentials:MS, DIPLOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 22ND ST
Mailing Address - Street 2:APT. B
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5686
Mailing Address - Country:US
Mailing Address - Phone:303-669-9323
Mailing Address - Fax:
Practice Address - Street 1:700 E 9TH AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3360
Practice Address - Country:US
Practice Address - Phone:303-233-3103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1180171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist