Healthcare Provider Details

I. General information

NPI: 1871892703
Provider Name (Legal Business Name): LAMAR DAY SPA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2011
Last Update Date: 03/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 N SCOTTSDALE RD
SCOTTSDALE AZ
85250
US

IV. Provider business mailing address

5115 N SCOTTSDALE RD
SCOTTSDALE AZ
85250
US

V. Phone/Fax

Practice location:
  • Phone: 480-945-7066
  • Fax: 480-212-0417
Mailing address:
  • Phone: 480-945-7066
  • Fax: 480-212-0417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number1022951
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1022951
License Number StateAZ

VIII. Authorized Official

Name: MS. HEIDI D LAMAR
Title or Position: OWNER
Credential:
Phone: 480-945-7066