MEDICARE: ARIZONA SCHOOL OF ACUPUNCTURE & ORIENTAL MEDICINE

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

General Provider Information

NPI Number	:	1457971624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA SCHOOL OF ACUPUNCTURE & ORIENTAL MEDICINE

Provider Business Mailing Address
First Line	:	2856 E FORT LOWELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-1518
Country	:	US
Telephone Number	:	520-795-5999
Fax Number	:

Provider Business Practice Location Address
First Line	:	2856 E FORT LOWELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-1518
Country	:	US
Telephone Number	:	520-795-5999
Fax Number	:

Authorized Official
Title or Position	:	CLINIC DEAN
Name	:	MR. NATHAN ASHER ANDERSON
Credential	:	L.AC.
Telephone Number	:	520-795-5999

Provider Enumeration Date	:	04/17/2020
Last Update Date	:	04/17/2020

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