Provider Demographics
NPI:1417295486
Name:ARNTSON, KRISTINA MARIE (LAC)
Entity Type:Individual
Prefix:MISS
First Name:KRISTINA
Middle Name:MARIE
Last Name:ARNTSON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 S LAMAR BLVD
Mailing Address - Street 2:SUITE 322
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-8962
Mailing Address - Country:US
Mailing Address - Phone:512-554-1533
Mailing Address - Fax:
Practice Address - Street 1:1700 S LAMAR BLVD
Practice Address - Street 2:SUITE 322
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-8962
Practice Address - Country:US
Practice Address - Phone:512-554-1533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00542171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist