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General NPI Number Information
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NPI Number | 1073475026
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Entity Type | Organization
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Legal Business Name | MYT HOLISTIC PLLC
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Dates
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Enumeration Date | 11/28/2025
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Last Update Date | 11/28/2025
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Provider Practice Location Address
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Address Line | 6699 FOX CENTRE PKWY UNIT #1014
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City | GLOUCESTER
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State | VA
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Zip | 23061
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Country | US
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Telephone | 757-204-1244
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Fax |
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Provider Business Mailing Address
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Address Line | 6699 FOX CENTRE PARKWAY BOX 431
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City | GLOUCESTER
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State | VA
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Zip | 23061
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Country | US
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Telephone | 757-204-1244
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAULA HUBBARD
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Credential | L. AC
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Telephone | 757-204-1244
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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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