Provider Demographics
NPI:1477893055
Name:BATES, SARA TORNES (LAC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:TORNES
Last Name:BATES
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 1:1730 S COLLEGE AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1073
Mailing Address - Country:US
Mailing Address - Phone:970-758-5777
Mailing Address - Fax:
Practice Address - Street 1:1730 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1073
Practice Address - Country:US
Practice Address - Phone:970-658-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-19
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002293171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist