Individual
MS. MARIA GRACE MANDARINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC & LMT
Contact information
Practice address
13000 NO 103RD AVE., SUITE 72, SUN CITY, AZ 85351
(623) 262-7222
Mailing address
13000 NO 103RD AVE., SUITE 72, SUN CITY, AZ 85351
(623) 262-7222
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
ACU 0001907
CO
171100000X
Acupuncturist
Primary
LAC001032
AZ
225700000X
Massage Therapist
MT-05542
AZ
225700000X
Massage Therapist
MT0013491
CO
Other
Enumeration date
03/21/2011
Last updated
08/15/2018
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