Provider Demographics
NPI:1851420087
Name:ROSIN, MARCEY ILENE (LAC)
Entity Type:Individual
Prefix:
First Name:MARCEY
Middle Name:ILENE
Last Name:ROSIN
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 1:2930 E GREENLEE ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1203
Mailing Address - Country:US
Mailing Address - Phone:520-904-1460
Mailing Address - Fax:520-325-3124
Practice Address - Street 1:2500 N TUCSON BLVD STE 130
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2463
Practice Address - Country:US
Practice Address - Phone:520-904-1460
Practice Address - Fax:520-325-3124
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0281171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist