Healthcare Provider Details

I. General information

NPI: 1730595281
Provider Name (Legal Business Name): ACUPUNCTURE AND WELLNESS OF OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2014
Last Update Date: 07/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8644 LITHOPOLIS RD
CARROLL OH
43112-9422
US

IV. Provider business mailing address

8644 LITHOPOLIS RD
CARROLL OH
43112-9422
US

V. Phone/Fax

Practice location:
  • Phone: 614-348-3127
  • Fax:
Mailing address:
  • Phone: 614-348-3127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number65.000184
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.013167-S
License Number StateOH

VIII. Authorized Official

Name: ADAM T. STEWART
Title or Position: LICENSED ACUPUNCTURIST
Credential: L.AC.
Phone: 614-348-3127