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NPI Code Detail

MEDICARE: MRS. JAMIE MARIE MOON L.AC.

MEDICARE:  MRS. JAMIE MARIE MOON  L.AC.
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
1171100000XAcupuncturist0814AZ

General Provider Information

NPI Number : 1689948978
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JAMIE MARIE MOON L.AC.
Provider Business Mailing Address
First Line : 6440 E BROADWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85710-3504
Country : US
Telephone Number : 520-881-0827
Fax Number :
Provider Business Practice Location Address
First Line : 6440 E BROADWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85710-3504
Country : US
Telephone Number : 520-881-0827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2012
Last Update Date : 10/02/2024

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Directions to “ MRS. JAMIE MARIE MOON L.AC.” Practice Location

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