Healthcare Provider Details

I. General information

NPI: 1184993453
Provider Name (Legal Business Name): INTEGRATIVE ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2011
Last Update Date: 12/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 CONGRESS PARK DR SUITE 230
DELRAY BEACH FL
33445-4670
US

IV. Provider business mailing address

220 CONGRESS PARK DR SUITE 230
DELRAY BEACH FL
33445-4670
US

V. Phone/Fax

Practice location:
  • Phone: 561-819-0530
  • Fax: 561-819-0521
Mailing address:
  • Phone: 561-819-0530
  • Fax: 561-819-0521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP2458
License Number StateFL

VIII. Authorized Official

Name: HARMONY R BROWN
Title or Position: ACUPUNCTURE PHYSICIAN
Credential: AP
Phone: 561-819-0530