Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 05-870 | AZ |
NPI | 1629482799 |
---|---|
Provider Name | Mrs. Sara R. Laroche |
First Address | Woodland Park, CO 80863 |
Second Address | Woodland Park, CO 80866 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2014 |
Last Update Date | 17/06/2014 |