Healthcare Provider Details

I. General information

NPI: 1598718488
Provider Name (Legal Business Name): SUMMIT ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/22/2020
Certification Date: 07/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 MEMMAN RD
AKRON OH
44313
US

IV. Provider business mailing address

1708 MEMMAN RD
AKRON OH
44313
US

V. Phone/Fax

Practice location:
  • Phone: 330-929-4334
  • Fax: 330-929-4353
Mailing address:
  • Phone: 330-929-4334
  • Fax: 330-929-4353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number65000037
License Number StateOH

VIII. Authorized Official

Name: MS. KIRSTEN VANNOSTRAN
Title or Position: PRESIDENT
Credential: LAC
Phone: 330-929-4334