Healthcare Provider Details

I. General information

NPI: 1588215115
Provider Name (Legal Business Name): TCM ACUPUNCTURE CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 S 78TH ST
OMAHA NE
68114-5411
US

IV. Provider business mailing address

1020 S 78TH ST
OMAHA NE
68114-5411
US

V. Phone/Fax

Practice location:
  • Phone: 402-981-5313
  • Fax:
Mailing address:
  • Phone: 402-981-5313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. TERESA S DUNNING
Title or Position: OWNER
Credential: LMT
Phone: 402-981-5313