Provider Demographics
NPI:1790226421
Name:WOOMER, SUZANNE (ND, L AC)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:WOOMER
Suffix:
Gender:F
Credentials:ND, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 RIVER ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3315
Mailing Address - Country:US
Mailing Address - Phone:203-442-6297
Mailing Address - Fax:833-520-5011
Practice Address - Street 1:117 RIVER ST UNIT B
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3315
Practice Address - Country:US
Practice Address - Phone:203-442-6297
Practice Address - Fax:833-520-5011
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-14
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT43.000690171100000X
CT000588175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist