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General NPI Number Information
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NPI Number | 1003050055
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE CLINIC
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Dates
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Enumeration Date | 04/21/2009
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Last Update Date | 04/21/2009
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Provider Practice Location Address
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Address Line | 204 PINEHURST DR SW SUITE #101
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City | TUMWATER
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State | WA
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Zip | 98501-4500
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Country | US
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Telephone | 360-753-7212
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Fax |
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Provider Business Mailing Address
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Address Line | 204 PINEHURST DR SW SUITE #101
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City | TUMWATER
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State | WA
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Zip | 98501-4500
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Country | US
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Telephone | 360-753-7212
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTUREST
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Name | MRS. BING ZHOU
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Credential |
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Telephone | 360-753-7212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | AC123
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License Number State | WA
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