Provider Demographics
NPI:1295103406
Name:MONETTE ATCHLEY, LLC
Entity type:Organization
Organization Name:MONETTE ATCHLEY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:MONETTE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ATCHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSAC, LAC, BSN
Authorized Official - Phone:602-350-4691
Mailing Address - Street 1:14435 N 7TH ST
Mailing Address - Street 2:SUITE 300A
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4371
Mailing Address - Country:US
Mailing Address - Phone:602-350-4691
Mailing Address - Fax:602-715-1966
Practice Address - Street 1:14435 N 7TH ST
Practice Address - Street 2:SUITE 300A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4371
Practice Address - Country:US
Practice Address - Phone:602-350-4691
Practice Address - Fax:602-715-1966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0934171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty