MEDICARE: NAMPHUENG MCKAY

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	225700000X	Massage Therapist	MT-27038	AZ

General Provider Information

NPI Number	:	1831709302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAMPHUENG MCKAY

Provider Business Mailing Address
First Line	:	165 W AJO WAY
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85713-6036
Country	:	US
Telephone Number	:	520-573-7734
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 W AJO WAY
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85713-6036
Country	:	US
Telephone Number	:	520-573-7734
Fax Number	:

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

Provider Enumeration Date	:	08/08/2020
Last Update Date	:	08/08/2020

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Directions to “ NAMPHUENG MCKAY ” Practice Location

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