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General NPI Number Information
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NPI Number | 1679385587
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Entity Type | Individual
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Provider Name | RICHARD ROSCA DACM
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Gender | Male
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 630 N 4TH AVE
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City | TUCSON
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State | AZ
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Zip | 85705-8449
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Country | US
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Telephone | 520-907-4333
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Fax |
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Provider Business Mailing Address
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Address Line | 5936 JACKSON RANCH RD
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City | WEED
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State | CA
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Zip | 96094-9608
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Country | US
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Telephone | 415-920-3285
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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 | LAC-012221
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License Number State | AZ
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