Healthcare Provider Details

I. General information

NPI: 1043603293
Provider Name (Legal Business Name): ROOT HEALING ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2015
Last Update Date: 03/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 MAIN ST SUITE 201
DUNEDIN FL
34698-4903
US

IV. Provider business mailing address

595 MAIN ST SUITE 201
DUNEDIN FL
34698-4903
US

V. Phone/Fax

Practice location:
  • Phone: 727-437-8582
  • Fax:
Mailing address:
  • Phone: 727-437-8582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP3311
License Number StateFL

VIII. Authorized Official

Name: DR. GENE HEALY
Title or Position: OWNER
Credential: AP
Phone: 727-437-8582