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Individual

ERNEST CONSTANTINE ESTEBAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5235 S KYRENE RD STE 105-264, TEMPE, AZ 85283-1779
(480) 466-7473
Mailing address
925 W BASELINE RD STE 105-264, TEMPE, AZ 85283-1100
(623) 203-9737
(480) 945-5339

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
000134
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000134
ACUPUNCTURE LICENSE
AZ
Enumeration date
12/14/2020
Last updated
12/14/2020
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