Healthcare Provider Details
I. General information
NPI: 1528449584
Provider Name (Legal Business Name): EMILY HURM L.AC., DIPL. O.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/16/2015
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3408 WOODLAND AVE SUITE #305
WEST DES MOINES IA
50266-6506
US
IV. Provider business mailing address
3408 WOODLAND AVE SUITE #305
WEST DES MOINES IA
50266-6506
US
V. Phone/Fax
- Phone: 515-556-3304
- Fax:
- Phone: 515-556-3304
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | A-83 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: