Provider Demographics
NPI:1316343064
Name:INVIGORATE ACUPUNCTURE PLLC
Entity type:Organization
Organization Name:INVIGORATE ACUPUNCTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:PRATTE
Authorized Official - Last Name:CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:520-370-6069
Mailing Address - Street 1:6416 E TANQUE VERDE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3825
Mailing Address - Country:US
Mailing Address - Phone:520-370-6069
Mailing Address - Fax:
Practice Address - Street 1:6416 E TANQUE VERDE RD
Practice Address - Street 2:SUITE B
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3825
Practice Address - Country:US
Practice Address - Phone:520-370-6069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0873171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty