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General NPI Number Information
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NPI Number | 1801513379
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Entity Type | Organization
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Legal Business Name | SUNRISE ACUPUNCTURE CLINIC
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Dates
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Enumeration Date | 10/25/2022
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 78 E 2700 S
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City | SOUTH SALT LAKE
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State | UT
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Zip | 84115-3132
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Country | US
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Telephone | 801-696-5791
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Fax |
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Provider Business Mailing Address
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Address Line | 78 E 2700 S
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City | SOUTH SALT LAKE
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State | UT
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Zip | 84115-3132
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Country | US
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Telephone | 801-355-8668
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAO SUN
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Credential | MD
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Telephone | 801-355-8668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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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 |
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License Number State |
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