Provider Demographics
NPI:1164869848
Name:WALDRON, KAMI L (LAC)
Entity Type:Individual
Prefix:MS
First Name:KAMI
Middle Name:L
Last Name:WALDRON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:KAMI
Other - Middle Name:L
Other - Last Name:WALDRON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:2051 LANSING ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-1327
Mailing Address - Country:US
Mailing Address - Phone:303-882-9420
Mailing Address - Fax:
Practice Address - Street 1:2051 LANSING ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-1327
Practice Address - Country:US
Practice Address - Phone:303-882-9420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU1904171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist