Healthcare Provider Details

I. General information

NPI: 1124227848
Provider Name (Legal Business Name): SYNERGY HOLISTIC HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 06/04/2020
Certification Date: 06/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7413 US 42 SUITE 3
FLORENCE KY
41042-1999
US

IV. Provider business mailing address

7413 US 42 SUITE 3
FLORENCE KY
41042-1999
US

V. Phone/Fax

Practice location:
  • Phone: 859-525-5000
  • Fax: 859-525-1530
Mailing address:
  • Phone: 859-525-5000
  • Fax: 859-525-1530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberKY AC 018
License Number StateKY

VIII. Authorized Official

Name: MRS. MARIE TAGHER
Title or Position: OWNER
Credential: LAC, LMT
Phone: 859-525-5000