Healthcare Provider Details

I. General information

NPI: 1467798892
Provider Name (Legal Business Name): HART ACUPUNCTURE & NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2012
Last Update Date: 06/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 FARMINGTON AVE
FARMINGTON CT
06032-1901
US

IV. Provider business mailing address

11 WALBRIDGE RD
WEST HARTFORD CT
06119-1344
US

V. Phone/Fax

Practice location:
  • Phone: 860-578-3172
  • Fax:
Mailing address:
  • Phone: 860-578-3172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number560
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number484
License Number StateCT

VIII. Authorized Official

Name: DR. KARA BURKHART
Title or Position: OWNER
Credential: ND, LAC
Phone: 860-578-3172