Organization
SUN BIRD ACUPUNCTURE & TRADITIONAL HERBS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENG SUN DTCM (MANGER)
(623) 552-0944
Entity
Organization
Contact information
Practice address
1845 W MARLETTE AVE, PHOENIX, AZ 85015-2039
(623) 552-0944
Mailing address
1845 W MARLETTE AVE, PHOENIX, AZ 85015-2039
(623) 552-0944
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
0844
AZ
Other
Enumeration date
04/10/2013
Last updated
04/10/2013
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