Healthcare Provider Details

I. General information

NPI: 1073441739
Provider Name (Legal Business Name): ANCIENT CITY ACUPUNCTURE AND HERBAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4475 US HIGHWAY 1 S STE 203
ST AUGUSTINE FL
32086-3203
US

IV. Provider business mailing address

4475 US HIGHWAY 1 S STE 203
ST AUGUSTINE FL
32086-3203
US

V. Phone/Fax

Practice location:
  • Phone: 904-797-2401
  • Fax: 904-679-5328
Mailing address:
  • Phone: 904-797-2401
  • Fax: 904-679-5328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. YVONNE CAMILLE TOWSLEY
Title or Position: PRESIDENT
Credential: AP MAOM DACM
Phone: 904-797-2401