Provider Demographics
NPI:1356488357
Name:SILAPALIKITPORN, TUTSIE NA (LAC)
Entity Type:Individual
Prefix:DR
First Name:TUTSIE
Middle Name:NA
Last Name:SILAPALIKITPORN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:DR
Other - First Name:TUTSIE
Other - Middle Name:NA
Other - Last Name:SILAPALIKITPORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:PO BOX 32086
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-2086
Mailing Address - Country:US
Mailing Address - Phone:602-954-4083
Mailing Address - Fax:
Practice Address - Street 1:5315 N 41ST ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-1605
Practice Address - Country:US
Practice Address - Phone:602-954-4083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0139171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist