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Individual

MR. JIMMY WOON FON LIU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.AC

Contact information

Practice address
5233 E SOUTHERN AVE, MESA, AZ 85206-3625
(480) 567-5267
Mailing address
530 E MCDOWELL RD # 107-405, PHOENIX, AZ 85004-1549
(480) 462-1590
(602) 715-1566

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1067
AZ
171100000X
Acupuncturist
AC12024
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AC12024
LICENSE
CA
01
LAC-1067
AZ STATE BOARD LICENSE
AZ
Enumeration date
11/02/2007
Last updated
06/07/2023
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