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General NPI Number Information
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NPI Number | 1316179153
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE & INTEGRATIVE HEALTH CARE OF ARIZONA LLC
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Dates
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Enumeration Date | 08/12/2009
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Last Update Date | 08/12/2009
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Provider Practice Location Address
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Address Line | 16842 E PARKVIEW AVE SUITE 2
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268-3825
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Country | US
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Telephone | 631-707-2044
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Fax |
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Provider Business Mailing Address
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Address Line | 16842 E PARKVIEW AVE SUITE 2
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268-3825
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Country | US
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Telephone | 631-707-2044
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Fax |
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | PAUL ALAN MCELDERRY
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Credential | L.AC., LMT, MS
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Telephone | 631-707-2044
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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 | 0647
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License Number State | AZ
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