Bahman Shahlori, DAC
Individual provider Active NPI Acupuncturist · Williams, AZ
NPI 1124769856 · NPPES record last updated Apr 5, 2022
Key facts
- NPI
- 1124769856
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- LAC-011375 (AZ)
- Practice address
- 900 Wells Fargo
Williams, AZ 86046-9777 - Phone
- (928) 599-4325
- NPI assigned
- Apr 5, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAC-011375 | AZ | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | LAC-011375 | AZ | Yes |
Addresses
Primary practice location
900 Wells Fargo
Williams, AZ 86046-9777
Mailing address
900 Wells Fargo
Williams, AZ 86046-9777
Phone (928) 599-4325
Other providers in Williams, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.