Provider Demographics
NPI:1609201219
Name:JENNIFER M. KATZ, L.AC, LLC
Entity Type:Organization
Organization Name:JENNIFER M. KATZ, L.AC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:720-217-2578
Mailing Address - Street 1:4957 W 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80030-5141
Mailing Address - Country:US
Mailing Address - Phone:720-217-2578
Mailing Address - Fax:303-429-4171
Practice Address - Street 1:4251 KIPLING ST
Practice Address - Street 2:SUITE 505
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2896
Practice Address - Country:US
Practice Address - Phone:720-217-2578
Practice Address - Fax:303-429-4171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO765171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty