MEDICARE: MARCEY ROSIN, L.AC., LLC

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	261Q00000X	Clinic/Center	0281	AZ

General Provider Information

NPI Number	:	1861839003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARCEY ROSIN, L.AC., LLC

Provider Business Mailing Address
First Line	:	2500 N TUCSON BLVD STE 130
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-2463
Country	:	US
Telephone Number	:	520-904-1460
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 N TUCSON BLVD STE 130
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-2463
Country	:	US
Telephone Number	:	520-904-1460
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SOLE PROPRIETOR
Name	:	MS. MARCEY ILENER ROSIN
Credential	:	5209041460
Telephone Number	:	520-904-1460

Provider Enumeration Date	:	05/29/2013
Last Update Date	:	05/29/2013

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