MEDICARE: NATHAN ASHER ANDERSON 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
1	171100000X	Acupuncturist	AC 9744	CA
2	171100000X	Acupuncturist	888	AZ

General Provider Information

NPI Number	:	1881891018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN ASHER ANDERSON L.AC.

Provider Business Mailing Address
First Line	:	2856 E FORT LOWELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-1518
Country	:	US
Telephone Number	:	520-999-0800
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	:	520-999-0800
Fax Number	:

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

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	08/18/2021

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