Provider Demographics
NPI:1841583481
Name:STRICKER, SUZANNE (LAC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:STRICKER
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 1:4730 TABLE MESA DR K100
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-1221
Mailing Address - Country:US
Mailing Address - Phone:303-915-1698
Mailing Address - Fax:
Practice Address - Street 1:4730 TABLE MESA DR K100
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-1221
Practice Address - Country:US
Practice Address - Phone:303-915-1698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1482171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist