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NPI Code Detail

MEDICARE: JOHNSON CITY ACUPUNCTURE AND HERBS LLC

MEDICARE: JOHNSON CITY ACUPUNCTURE AND HERBS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1302F00000XExclusive Provider OrganizationACU166TN

General Provider Information

NPI Number : 1487039103
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHNSON CITY ACUPUNCTURE AND HERBS LLC
Provider Business Mailing Address
First Line : 1093 WILLOW SPRINGS DR
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-3224
Country : US
Telephone Number : 423-544-1806
Fax Number :
Provider Business Practice Location Address
First Line : 206 PRINCETON RD STE 31B
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-2025
Country : US
Telephone Number : 423-544-1806
Fax Number :
Authorized Official
Title or Position : MEMBER, LAC
Name : SUMALEE T GRIFFITH
Credential :
Telephone Number : 423-544-1806
Provider Enumeration Date : 07/23/2015
Last Update Date : 07/23/2015

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Directions to “JOHNSON CITY ACUPUNCTURE AND HERBS LLC ” Practice Location

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