Healthcare Provider Details
I. General information
NPI: 1609268325
Provider Name (Legal Business Name): CLINIC OF ALTERNATIVE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/04/2015
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3420 DUCK AVE
KEY WEST FL
33040-4427
US
IV. Provider business mailing address
3420 DUCK AVE
KEY WEST FL
33040-4427
US
V. Phone/Fax
- Phone: 305-296-5358
- Fax: 305-293-1146
- Phone: 305-296-5358
- Fax: 305-293-1146
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASHLEY
HOYT
Title or Position: OWNER
Credential: A.P., M.T.
Phone: 305-296-5358