Healthcare Provider Details

I. General information

NPI: 1346724184
Provider Name (Legal Business Name): ACCUPUNCTURE CENTER OF TOLEDO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4739 MONROE ST STE B
TOLEDO OH
43623-4342
US

IV. Provider business mailing address

4739 MONROE ST STE B
TOLEDO OH
43623-4342
US

V. Phone/Fax

Practice location:
  • Phone: 419-754-1030
  • Fax: 419-754-1030
Mailing address:
  • Phone: 419-754-1030
  • Fax: 419-754-1030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: FARZANA N TAUSIF
Title or Position: OWNER
Credential: MD
Phone: 419-754-1030