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General NPI Number Information
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NPI Number | 1083346019
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Entity Type | Individual
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Provider Name | MICHAEL RYAN HARTLAUB L.AC.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 75 CLAIREDAN DR STE G
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City | POWELL
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State | OH
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Zip | 43065-3505
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Country | US
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Telephone | 614-505-9363
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Fax |
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Provider Business Mailing Address
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Address Line | 7501 SAWMILL COMMONS LN APT L
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City | DUBLIN
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State | OH
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Zip | 43016-8592
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Country | US
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Telephone | 330-819-2765
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 65.000309
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License Number State | OH
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