Provider Demographics
NPI:1902083041
Name:SAKOWICH, MICHAEL (DIPL OM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:SAKOWICH
Suffix:
Gender:M
Credentials:DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3112
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:CO
Mailing Address - Zip Code:80466-3112
Mailing Address - Country:US
Mailing Address - Phone:720-352-5415
Mailing Address - Fax:
Practice Address - Street 1:2885 AURORA AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2250
Practice Address - Country:US
Practice Address - Phone:720-352-5415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1157171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist