Provider Demographics
NPI:1891021622
Name:MASTER LU'S HEALTH CENTER
Entity Type:Organization
Organization Name:MASTER LU'S HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/BILLING
Authorized Official - Prefix:
Authorized Official - First Name:BETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCARIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-463-1101
Mailing Address - Street 1:3220 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-3836
Mailing Address - Country:US
Mailing Address - Phone:801-463-1101
Mailing Address - Fax:801-463-1197
Practice Address - Street 1:3220 S STATE ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-3836
Practice Address - Country:US
Practice Address - Phone:801-463-1101
Practice Address - Fax:801-463-1197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty