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General NPI Number Information
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NPI Number | 1639782253
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Entity Type | Individual
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Provider Name | JUSTIN GARCIA L.AC.
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Gender | Male
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Dates
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Enumeration Date | 08/24/2020
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 6622 N 91ST AVE STE 230
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City | GLENDALE
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State | AZ
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Zip | 85305-2570
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Country | US
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Telephone | 602-325-2024
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Fax | 720-925-5897
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Provider Business Mailing Address
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Address Line | 5445 DTC PKWY STE 1130
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-3038
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Country | US
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Telephone | 720-749-5599
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Fax |
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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 | 18825
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | LAC-012235
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License Number State | AZ
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