Provider Demographics
NPI:1952815334
Name:HOLPUCH, MEGHAN MAIBACH (ND)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:MAIBACH
Last Name:HOLPUCH
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 LINCOLN AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-5186
Mailing Address - Country:US
Mailing Address - Phone:970-778-4222
Mailing Address - Fax:970-623-7105
Practice Address - Street 1:1041 LINCOLN AVE STE 301
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-5186
Practice Address - Country:US
Practice Address - Phone:970-778-4222
Practice Address - Fax:970-457-5485
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000153175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath