MEDICARE: SARASELENE HAUSMAN L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	0913	AZ

General Provider Information

NPI Number	:	1659775377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARASELENE HAUSMAN L.AC.

Provider Business Mailing Address
First Line	:	4503 N 32ND ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-3339
Country	:	US
Telephone Number	:	602-956-8222
Fax Number	:	602-956-8333

Provider Business Practice Location Address
First Line	:	4503 N 32ND ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-3339
Country	:	US
Telephone Number	:	602-956-8222
Fax Number	:	602-956-8333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2014
Last Update Date	:	10/09/2014

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Directions to “ SARASELENE HAUSMAN L.AC.” Practice Location

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