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General NPI Number Information
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NPI Number | 1043451933
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE WELLNESS CENTER OF CORAL SPRINGS P.A.
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Dates
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Enumeration Date | 03/23/2009
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Last Update Date | 03/23/2009
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Provider Practice Location Address
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Address Line | 10139 NW 31ST ST STE 101
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-3908
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Country | US
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Telephone | 954-755-1292
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Fax | 954-755-4029
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Provider Business Mailing Address
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Address Line | 10139 NW 31ST ST STE 101
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-3908
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Country | US
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Telephone | 954-755-1292
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Fax | 954-755-4029
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Authorized Official
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Title or Position | OWNER
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Name | DR. JACK TOBOL
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Credential | A.P
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Telephone | 954-755-1292
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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 | AP1984
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License Number State | FL
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