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General NPI Number Information
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NPI Number | 1073264149
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Entity Type | Organization
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Legal Business Name | A CHANGE OF HEALTH ACUPUNCTURE CLINIC
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 4001 WALLI STRASSE DR
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City | BURTON
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State | MI
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Zip | 48509-1729
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Country | US
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Telephone | 810-715-7746
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Fax |
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Provider Business Mailing Address
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Address Line | 4001 WALLI STRASSE DR
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City | BURTON
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State | MI
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Zip | 48509-1729
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Country | US
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Telephone | 810-715-7746
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | MR. RAMIE YELLE
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Credential | LAC
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Telephone | 810-835-5616
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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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