Provider Demographics
NPI:1518256320
Name:VAN DUN, BRITTA (LAC, MS, EDM)
Entity Type:Individual
Prefix:MS
First Name:BRITTA
Middle Name:
Last Name:VAN DUN
Suffix:
Gender:F
Credentials:LAC, MS, EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4390 W CAMINO NUESTRO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-9390
Mailing Address - Country:US
Mailing Address - Phone:917-519-2432
Mailing Address - Fax:
Practice Address - Street 1:4390 W CAMINO NUESTRO
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-9390
Practice Address - Country:US
Practice Address - Phone:917-519-2432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0830171100000X
NY004425171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist