Provider Demographics
NPI:1144776519
Name:ZYLLA ACUPUNCTURE PLC
Entity Type:Organization
Organization Name:ZYLLA ACUPUNCTURE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRETON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:520-539-7243
Mailing Address - Street 1:3210 E FORT LOWELL RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1682
Mailing Address - Country:US
Mailing Address - Phone:520-539-7343
Mailing Address - Fax:
Practice Address - Street 1:3210 E FORT LOWELL RD
Practice Address - Street 2:SUITE 103
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1682
Practice Address - Country:US
Practice Address - Phone:520-539-7343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0779171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty