Organization
CITY ACUPUNCTURE
Active
Parent organization
PROVIDENCE ENTERPRISES LLC
Other names
Providence Enterprises LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE ENTERPRISES LLC
Authorized official
JENNIFER PROVIDENCE LAC (OWNER)
(520) 332-5509
Entity
Organization
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
261QP3300X
Pain Clinic/Center
Primary
1046
AZ
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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