Healthcare Provider Details

I. General information

NPI: 1184169948
Provider Name (Legal Business Name): ACUPUNCTURE WORKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2017
Last Update Date: 01/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14323 OCEAN HWY UNIT 4129
PAWLEYS ISLAND SC
29585-4817
US

IV. Provider business mailing address

14323 OCEAN HWY UNIT 4129
PAWLEYS ISLAND SC
29585-4817
US

V. Phone/Fax

Practice location:
  • Phone: 843-455-4228
  • Fax: 843-504-3179
Mailing address:
  • Phone: 843-455-4228
  • Fax: 843-504-3179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number127
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number1881
License Number StateSC

VIII. Authorized Official

Name: LESLIE JAFARACE
Title or Position: OWNER/ACUPUNCTURIST
Credential: L.AC
Phone: 843-455-4228