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NPI Code Detail

MEDICARE: CRYSTAL MAYLONE DIPL.AC., L.AC., LMT

MEDICARE:   CRYSTAL  MAYLONE  DIPL.AC., L.AC., LMT
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
1171100000XAcupuncturist0900AZ

General Provider Information

NPI Number : 1487392338
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL MAYLONE DIPL.AC., L.AC., LMT
Provider Business Mailing Address
First Line : 10221 N 32ND ST STE E
Second Line :
City : PHOENIX
State : AZ
Zip : 85028-3849
Country : US
Telephone Number : 623-252-4957
Fax Number :
Provider Business Practice Location Address
First Line : 10221 N 32ND ST STE E
Second Line :
City : PHOENIX
State : AZ
Zip : 85028-3849
Country : US
Telephone Number : 623-252-4957
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2022
Last Update Date : 05/20/2022

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Directions to “ CRYSTAL MAYLONE DIPL.AC., L.AC., LMT” Practice Location

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