Provider Demographics
NPI:1720438088
Name:DEBORAH L MALONE LAC LLC
Entity type:Organization
Organization Name:DEBORAH L MALONE LAC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:520-471-7808
Mailing Address - Street 1:3120 N TERRELL PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1525
Mailing Address - Country:US
Mailing Address - Phone:520-471-7808
Mailing Address - Fax:520-319-9712
Practice Address - Street 1:639 E SPEEDWAY BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-7433
Practice Address - Country:US
Practice Address - Phone:520-471-7808
Practice Address - Fax:520-319-9712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0086171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty