Provider Demographics
NPI:1710711593
Name:PURE INTENT ACUPUNCTURE, LLC
Entity type:Organization
Organization Name:PURE INTENT ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ALEJANDRA
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:602-615-1916
Mailing Address - Street 1:107 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85701-1011
Mailing Address - Country:US
Mailing Address - Phone:602-615-1916
Mailing Address - Fax:
Practice Address - Street 1:107 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-1011
Practice Address - Country:US
Practice Address - Phone:602-615-1916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty