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General NPI Number Information
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NPI Number | 1003322926
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Entity Type | Organization
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Legal Business Name | MILLENNIUM ACUPUNCTURE
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Dates
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Enumeration Date | 12/15/2017
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Last Update Date | 12/15/2017
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Provider Practice Location Address
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Address Line | 6161 E PIMA ST TUCSON AZ 85712 APT 2074
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City | TUCSON
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State | AZ
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Zip | 85712
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Country | US
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Telephone | 520-551-0451
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Fax |
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Provider Business Mailing Address
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Address Line | 6161 E PIMA ST TUCSON AZ 85712 APT 2074
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City | TUCSON
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State | AZ
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Zip | 85712
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Country | US
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Telephone | 520-551-0451
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. LOREN M STARKS
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Credential | MA
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Telephone | 520-551-0451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 0915
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License Number State | AZ
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