NPI 1053775692

Roxene Bates, LACDIPLOM

Practitioner Acupuncturist Providence, UT

Practice location

Address: 19 S Main St, Providence, UT 84332-9786
Phone: (818) 519-5083
Mailing address: PO Box 1, Providence, UT 84332-0001

Registered specialties

Acupuncturist Primary

Other Service Providers Taxonomy 171100000X Licence 9654360-1201 (UT)

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Registry record

NPI: 1053775692
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Apr 2016
Record last updated: 10 Apr 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.