MEDICARE: ALEXIS MARIE STARNES 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	1107	AZ

General Provider Information

NPI Number	:	1972099612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS MARIE STARNES L.AC

Provider Business Mailing Address
First Line	:	4629 N 9TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-3813
Country	:	US
Telephone Number	:	916-375-9237
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 W MCDOWELL RD STE 5
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85003-1211
Country	:	US
Telephone Number	:	916-375-9237
Fax Number	:

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

Provider Enumeration Date	:	07/05/2018
Last Update Date	:	07/05/2018

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