MEDICARE: MARY ELIZABETH SPENCER ACUPUNCTURIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	LAC-011979	AZ

General Provider Information

NPI Number	:	1376193441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ELIZABETH SPENCER ACUPUNCTURIST

Provider Business Mailing Address
First Line	:	181 W BLACKSTONE RD
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85755-8948
Country	:	US
Telephone Number	:	520-229-7924
Fax Number	:

Provider Business Practice Location Address
First Line	:	4008 E PIMA ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-3317
Country	:	US
Telephone Number	:	520-322-9355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2019
Last Update Date	:	05/19/2023

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