Healthcare Provider Details

I. General information

NPI: 1508663766
Provider Name (Legal Business Name): ACUPUNCTURE ONE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W6905 PARKVIEW DR STE A
GREENVILLE WI
54942-9099
US

IV. Provider business mailing address

W6905 PARKVIEW DR STE A
GREENVILLE WI
54942-9099
US

V. Phone/Fax

Practice location:
  • Phone: 920-757-9887
  • Fax: 920-221-3337
Mailing address:
  • Phone: 920-757-9887
  • Fax: 920-221-3337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: JAMES RODOWCA
Title or Position: ACUPUNCTURIST
Credential:
Phone: 920-757-9887