Healthcare Provider Details

I. General information

NPI: 1790010072
Provider Name (Legal Business Name): KLIMICK ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10979 REED HARTMAN HWY SUITE 129
CINCINNATI OH
45242-2800
US

IV. Provider business mailing address

10979 REED HARTMAN HWY SUITE 129
CINCINNATI OH
45242-2800
US

V. Phone/Fax

Practice location:
  • Phone: 513-834-8173
  • Fax:
Mailing address:
  • Phone: 513-834-8173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number65.000160
License Number StateOH

VIII. Authorized Official

Name: GIGI KLIMICK PEREIRA
Title or Position: OWNER
Credential: L.AC.
Phone: 513-834-8173