Provider Demographics
NPI:1225465982
Name:KERZNER, PAUL ROSS (LAC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ROSS
Last Name:KERZNER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4300 N MILLER RD STE 144
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3621
Mailing Address - Country:US
Mailing Address - Phone:480-442-3392
Mailing Address - Fax:480-682-4992
Practice Address - Street 1:4300 N MILLER RD STE 144
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3621
Practice Address - Country:US
Practice Address - Phone:480-442-3392
Practice Address - Fax:480-682-4992
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ0894171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist