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General NPI Number Information
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NPI Number | 1558514265
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Entity Type | Individual
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Provider Name | LINDA KELLEY L.AC.
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Gender | Female
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Dates
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Enumeration Date | 10/24/2008
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Last Update Date | 10/24/2008
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Provider Practice Location Address
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Address Line | 12580 W BEARDSLEY RD
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-3353
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Country | US
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Telephone | 602-341-9122
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Fax | 623-236-8644
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Provider Business Mailing Address
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Address Line | 6740 W DEER VALLEY RD PMB 224 SUITE D-107
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City | GLENDALE
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State | AZ
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Zip | 85310-5953
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Country | US
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Telephone | 602-341-9122
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Fax | 623-236-8644
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0520
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License Number State | AZ
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