Healthcare Provider Details

I. General information

NPI: 1558837344
Provider Name (Legal Business Name): SOUTH JERSEY ACUPUNCTURE AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2018
Last Update Date: 10/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 WHITE HORSE PIKE
WEST COLLINGSWOOD NJ
08107-1730
US

IV. Provider business mailing address

201 W CRYSTAL LAKE AVE
HADDONFIELD NJ
08033-3200
US

V. Phone/Fax

Practice location:
  • Phone: 609-458-0340
  • Fax: 856-333-6130
Mailing address:
  • Phone: 856-571-2271
  • Fax: 856-333-6130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RACHEL WEISS
Title or Position: OWNER
Credential: L. AC.
Phone: 856-571-2271