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General NPI Number Information
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NPI Number | 1003656737
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Entity Type | Organization
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Legal Business Name | HACKETT ACUPUNCTURE CLINIC PA
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 3064 UNIVERSITY PKWY
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City | SARASOTA
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State | FL
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Zip | 34243-2502
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Country | US
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Telephone | 941-377-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 3064 UNIVERSITY PKWY
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City | SARASOTA
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State | FL
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Zip | 34243-2502
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Country | US
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Telephone | 941-377-4325
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURE PHYSICIAN
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Name | DEENA HACKETT
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Credential | DOM
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Telephone | 941-377-4325
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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 |
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License Number State |
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