MEDICARE: RENEE IRENE STUCKLEN LAC, DIPL. OM; 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
1	171100000X	Acupuncturist	0884	AZ

General Provider Information

NPI Number	:	1609217215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE IRENE STUCKLEN LAC, DIPL. OM; LMT

Provider Business Mailing Address
First Line	:	PO BOX 64403
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85728-4403
Country	:	US
Telephone Number	:	520-849-9003
Fax Number	:

Provider Business Practice Location Address
First Line	:	282 E RIVER RD STE 101
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-5838
Country	:	US
Telephone Number	:	520-849-9003
Fax Number	:	520-783-9003

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

Provider Enumeration Date	:	07/11/2013
Last Update Date	:	02/19/2026

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