Provider Demographics
NPI:1013524958
Name:POMERANTZ, LISA EVELYN (ND)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:EVELYN
Last Name:POMERANTZ
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 1:2142 EMERY ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-1418
Mailing Address - Country:US
Mailing Address - Phone:516-807-6854
Mailing Address - Fax:
Practice Address - Street 1:2142 EMERY ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-1418
Practice Address - Country:US
Practice Address - Phone:516-807-6854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath