Provider Demographics
NPI:1649821224
Name:CHEUNG, ROWENA TING-TING
Entity type:Individual
Prefix:
First Name:ROWENA
Middle Name:TING-TING
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9013
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85068-9013
Mailing Address - Country:US
Mailing Address - Phone:602-373-8818
Mailing Address - Fax:
Practice Address - Street 1:10821 N 23RD ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-2404
Practice Address - Country:US
Practice Address - Phone:623-696-6766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-010077171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist