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General NPI Number Information
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NPI Number | 1720438088
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Entity Type | Organization
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Legal Business Name | DEBORAH L MALONE LAC LLC
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Dates
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Enumeration Date | 06/17/2016
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Last Update Date | 06/17/2016
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Provider Practice Location Address
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Address Line | 639 E SPEEDWAY BLVD
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City | TUCSON
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State | AZ
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Zip | 85705-7433
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Country | US
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Telephone | 520-471-7808
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Fax | 520-319-9712
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Provider Business Mailing Address
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Address Line | 3120 N TERRELL PL
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City | TUCSON
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State | AZ
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Zip | 85716-1525
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Country | US
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Telephone | 520-471-7808
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Fax | 520-319-9712
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Authorized Official
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Title or Position | LICENSED ACUPUNCTURIST
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Name | DEBORAH LYNN MALONE
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Credential | LAC
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Telephone | 520-471-7808
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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 | 0086
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License Number State | AZ
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