Provider Demographics
NPI:1659837854
Name:PREDKI-WEBER, JULIE (LAC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:PREDKI-WEBER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:PREDKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4856 S ZANG WAY
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-1629
Mailing Address - Country:US
Mailing Address - Phone:312-914-2278
Mailing Address - Fax:
Practice Address - Street 1:1776 S JACKSON ST STE 615
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3803
Practice Address - Country:US
Practice Address - Phone:312-914-2278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2003171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist