Provider Demographics
NPI:1548022072
Name:KUO, YA-FANG
Entity type:Individual
Prefix:
First Name:YA-FANG
Middle Name:
Last Name:KUO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 MORGAN RD
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-6601
Mailing Address - Country:US
Mailing Address - Phone:510-439-7812
Mailing Address - Fax:
Practice Address - Street 1:172 E MERRITT ST STE C
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-2027
Practice Address - Country:US
Practice Address - Phone:928-642-5382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-010745171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist