Individual
JENNIFER PROVIDENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
300 S PARK AVE, TUCSON, AZ 85719-6130
(520) 332-5509
Mailing address
3349 E PRESIDIO RD, TUCSON, AZ 85716-1633
(520) 332-5509
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1046
AZ
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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