Healthcare Provider Details

I. General information

NPI: 1609549047
Provider Name (Legal Business Name): FR ACUPUNCTURE & CHINESE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2021
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 N TUCSON BLVD STE 12
TUCSON AZ
85716-3405
US

IV. Provider business mailing address

1601 N TUCSON BLVD STE 12
TUCSON AZ
85716-3405
US

V. Phone/Fax

Practice location:
  • Phone: 520-323-3056
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PING XIE
Title or Position: MANAGER
Credential:
Phone: 520-323-3056