Organization
LAUGHING MOON CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIRAH CAROLYN CLARK BA (ADMINISTRATOR)
(520) 682-7886
Entity
Organization
Contact information
Practice address
4251 N SANDERS RD, TUCSON, AZ 85743-7716
(520) 682-7886
(520) 616-7140
Mailing address
4251 N SANDERS RD, TUCSON, AZ 85743-7716
(520) 682-7886
(520) 616-7140
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
BH2126
AZ
Other
Enumeration date
12/01/2006
Last updated
08/22/2020
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