Healthcare Provider Details

I. General information

NPI: 1710155981
Provider Name (Legal Business Name): CHRISTY ANN CLINE NMD, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 06/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16429 N TATUM BLVD SUITE 200
PHOENIX AZ
85032-3458
US

IV. Provider business mailing address

13835 N TATUM BLVD STE 9 #274
PHOENIX AZ
85032-5582
US

V. Phone/Fax

Practice location:
  • Phone: 480-529-3732
  • Fax:
Mailing address:
  • Phone: 480-529-3732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0581
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number07-1002
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: