Healthcare Provider Details

I. General information

NPI: 1942802400
Provider Name (Legal Business Name): S&A ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 11/10/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 SOUTH WOODS DRIVE
ROCKLEDGE FL
32955-3262
US

IV. Provider business mailing address

154 SOUTH WOODS DRIVE
ROCKLEDGE FL
32955-3262
US

V. Phone/Fax

Practice location:
  • Phone: 321-639-7066
  • Fax: 321-639-7091
Mailing address:
  • Phone: 321-639-7066
  • Fax: 321-639-7091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. SHU-LI TSENG CHANG
Title or Position: ACUPUNCTURE PHYSICIAN
Credential: DOM
Phone: 321-639-7066