Provider Demographics
NPI:1023353349
Name:STRONG, KATHRYN POLLARD (LAC)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:POLLARD
Last Name:STRONG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:MARYKATHRYN
Other - Middle Name:POLLARD
Other - Last Name:STRONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:6665 GARRISON ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-3058
Mailing Address - Country:US
Mailing Address - Phone:303-456-2033
Mailing Address - Fax:303-456-2033
Practice Address - Street 1:6665 GARRISON ST
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-3058
Practice Address - Country:US
Practice Address - Phone:303-456-2033
Practice Address - Fax:303-456-2033
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0001801171100000X
CAAC 14634171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist