Provider Demographics
NPI:1619273489
Name:ARZANIPOUR, FLORA (LAC)
Entity Type:Individual
Prefix:MRS
First Name:FLORA
Middle Name:
Last Name:ARZANIPOUR
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 1:9250 COLUMBIA AVE
Mailing Address - Street 2:SUITE E-2
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-3538
Mailing Address - Country:US
Mailing Address - Phone:219-803-5006
Mailing Address - Fax:
Practice Address - Street 1:9250 COLUMBIA AVE
Practice Address - Street 2:SUITE E-2
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3538
Practice Address - Country:US
Practice Address - Phone:219-803-5006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN84000118A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist