Healthcare Provider Details

I. General information

NPI: 1679617310
Provider Name (Legal Business Name): STEVEN COONER LAC LMT OMD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3080 N CIVIC CT PLAZA SUITE 12
SCOTTSDALE AZ
85251
US

IV. Provider business mailing address

4725 N 73RD ST
SCOTTSDALE AZ
85251
US

V. Phone/Fax

Practice location:
  • Phone: 602-625-6612
  • Fax: 480-945-9053
Mailing address:
  • Phone: 602-625-6612
  • Fax: 480-945-9053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0103
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0910000028
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT03746P
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: