Healthcare Provider Details

I. General information

NPI: 1013791896
Provider Name (Legal Business Name): ACUPUNCTURE AND HEALING ARTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 S CHARLES RICHARD BEALL BLVD STE 2
DEBARY FL
32713-3273
US

IV. Provider business mailing address

135 DELEON RD
DEBARY FL
32713-2903
US

V. Phone/Fax

Practice location:
  • Phone: 386-742-9454
  • Fax:
Mailing address:
  • Phone: 386-742-9454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MARNA RASMUSSSEN
Title or Position: OWNER
Credential: AP
Phone: 386-742-9454