Provider Demographics
NPI:1760160519
Name:HARTZMAN, MAURA (DACM, DIP OM, LAC)
Entity Type:Individual
Prefix:DR
First Name:MAURA
Middle Name:
Last Name:HARTZMAN
Suffix:
Gender:F
Credentials:DACM, DIP OM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 S 1100 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3400
Mailing Address - Country:US
Mailing Address - Phone:336-509-8945
Mailing Address - Fax:
Practice Address - Street 1:1760 S 1100 E STE 3
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-3492
Practice Address - Country:US
Practice Address - Phone:435-315-2616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC-2084171100000X
UT13412435-1201171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist