Healthcare Provider Details

I. General information

NPI: 1609412857
Provider Name (Legal Business Name): MOLLY SWEET P.AC., H.H.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 06/29/2020
Certification Date: 06/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 MIGALDI LN STE 300
LANSING MI
48917-7758
US

IV. Provider business mailing address

644 MIGALDI LN STE 300
LANSING MI
48917-7758
US

V. Phone/Fax

Practice location:
  • Phone: 517-388-1507
  • Fax:
Mailing address:
  • Phone: 517-388-1507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: