Provider Demographics
NPI:1013409804
Name:TUCSON ACUPUNCTURE CENTER
Entity Type:Organization
Organization Name:TUCSON ACUPUNCTURE CENTER
Other - Org Name:TUCSON ACUPUNCTURE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:520-668-5210
Mailing Address - Street 1:800 N SWAN RD STE 106
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1256
Mailing Address - Country:US
Mailing Address - Phone:520-668-5210
Mailing Address - Fax:
Practice Address - Street 1:800 N SWAN RD STE 106
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1256
Practice Address - Country:US
Practice Address - Phone:520-668-5210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty