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General NPI Number Information
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NPI Number | 1003356387
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Entity Type | Organization
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Legal Business Name | NATURAL STATE ACUPUNCTURE LLC
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 1 HALSTED CIR SUITE 3
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City | ROGERS
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State | AR
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Zip | 72756-3150
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Country | US
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Telephone | 479-644-3516
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Fax |
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Provider Business Mailing Address
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Address Line | 1 HALSTED CIR SUITE 3
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City | ROGERS
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State | AR
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Zip | 72756-3150
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | BRETT ROBBINS
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Credential |
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Telephone | 479-644-3516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | L.AC. 070
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License Number State | AR
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