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General NPI Number Information
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NPI Number | 1164844270
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Entity Type | Organization
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Legal Business Name | CYPRESS PAVILION
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Dates
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Enumeration Date | 01/08/2014
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 7026 E 1ST AVE
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-4304
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Country | US
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Telephone | 480-949-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 7026 E 1ST AVE
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-4304
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Country | US
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Telephone | 480-949-1800
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | BRYON POWERS
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Credential | L. AC.
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Telephone | 480-949-1800
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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 | 0751
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License Number State | AZ
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