Healthcare Provider Details
I. General information
NPI: 1750855177
Provider Name (Legal Business Name): HAPPY SUNFLOWER ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2019
Last Update Date: 02/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2056 PORTAGE RD STE 6
WOOSTER OH
44691-1900
US
IV. Provider business mailing address
2650 WINCHESTER WOODS APT I
WOOSTER OH
44691-5333
US
V. Phone/Fax
- Phone: 330-234-1226
- Fax:
- Phone: 330-234-1226
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THERESE
K
BYRNE
Title or Position: OWNER
Credential: LAC., LMT
Phone: 330-234-1226