Healthcare Provider Details
I. General information
NPI: 1043752934
Provider Name (Legal Business Name): ART OF NATURAL HEALING LTD.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/09/2016
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7773 LAKE ST
RIVER FOREST IL
60305-1736
US
IV. Provider business mailing address
7773 LAKE ST.
RIVER FOREST IL
60305
US
V. Phone/Fax
- Phone: 708-366-8002
- Fax:
- Phone: 708-366-8002
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KELSEY
FERNANDEZ
Title or Position: OWNER PRESIDENT
Credential: DIPL. O.M, L.AC., ND
Phone: 708-366-8002