Individual
ROXENE BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC, DIPL OM
Contact information
Practice address
19 S MAIN ST, PROVIDENCE, UT 84332-9786
(818) 519-5083
Mailing address
PO BOX 1, PROVIDENCE, UT 84332-0001
(818) 519-5083
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
9654360-1201
UT
Other
Enumeration date
04/10/2016
Last updated
04/10/2016
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