Roxene Bates, LAC, DIPL OM

NPI #1053775692 in Providence, Utah

Provider Information

NPI Number: 1053775692
Entity Type: Individual
Name: Roxene Bates, LAC, DIPL OM
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Acupuncturist
Credential: LAC, DIPL OM
Enumeration Date: Apr 10, 2016
Last Updated: Apr 10, 2016

Practice Location

Address: 19 S MAIN ST
City: Providence
State: Utah
ZIP Code: 84332-9786
Phone: (818) 519-5083

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Acupuncturist	171100000X	Primary

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