Provider Demographics
NPI:1790662476
Name:TUCSON INTEGRATIVE ACUPUNCTURE PLLC
Entity type:Organization
Organization Name:TUCSON INTEGRATIVE ACUPUNCTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ROBERGE
Authorized Official - Suffix:JR
Authorized Official - Credentials:LAC
Authorized Official - Phone:520-273-2588
Mailing Address - Street 1:1414 W CALLE PLATINO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2778
Mailing Address - Country:US
Mailing Address - Phone:520-273-2588
Mailing Address - Fax:480-436-5339
Practice Address - Street 1:204 W GRANT RD UNIT 110
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-5507
Practice Address - Country:US
Practice Address - Phone:520-273-2588
Practice Address - Fax:480-436-5339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center