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General NPI Number Information
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NPI Number | 1871662593
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Entity Type | Individual
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Provider Name | ALISSA MARJORIE STOCKTON L.AC., D.O.M.
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Gender | Female
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 05/26/2015
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Provider Practice Location Address
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Address Line | 1059 N. COLLEGE AVE.
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City | THATCHER
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State | AZ
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Zip | 85552
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Country | US
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Telephone | 928-965-9545
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Fax |
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Provider Business Mailing Address
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Address Line | 1059 N. COLLEGE AVE. PO BOX 1119
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City | THATCHER
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State | AZ
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Zip | 85552
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Country | US
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Telephone | 928-965-9545
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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 | 0373
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License Number State | AZ
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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 | AZ0373
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License Number State | AZ
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