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General NPI Number Information
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NPI Number | 1013344373
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Entity Type | Organization
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Legal Business Name | BLACK PEARL ACUPUNCTURE LLC
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 8701 N US HIGHWAY 1
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City | SEBASTIAN
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State | FL
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Zip | 32958-7570
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Country | US
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Telephone | 772-202-2820
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Fax |
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Provider Business Mailing Address
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Address Line | 8701 N US HIGHWAY 1
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City | SEBASTIAN
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State | FL
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Zip | 32958-7570
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Country | US
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Telephone | 772-202-2820
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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 | DR. KAREN MARIE BATTLE
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Credential | A.P.,D.O.M.
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Telephone | 772-202-2820
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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 | AP2557
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License Number State | FL
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