MEDICARE: KARSTEN ALEXANDRIA N.D., 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	0171
2	175F00000X	Naturopath	96-473	AZ

General Provider Information

NPI Number	:	1932346715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARSTEN ALEXANDRIA N.D., L.AC.

Provider Business Mailing Address
First Line	:	1420 E. NORTHERN AVE.
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-4317
Country	:	US
Telephone Number	:	602-938-8200
Fax Number	:	602-938-8519

Provider Business Practice Location Address
First Line	:	1420 E. NORTHERN AVE.
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-4317
Country	:	US
Telephone Number	:	602-938-8200
Fax Number	:	602-938-8519

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

Provider Enumeration Date	:	01/15/2009
Last Update Date	:	01/15/2009

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