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General NPI Number Information
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NPI Number | 1093306334
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Entity Type | Organization
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Legal Business Name | PLUMERIA ACUPUNCTURE AND HOLISTIC WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 01/29/2021
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 2500 N MAYFAIR RD
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City | WAUWATOSA
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State | WI
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Zip | 53226-1409
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Country | US
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Telephone | 414-687-0087
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 N MAYFAIR RD STE 410
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City | WAUWATOSA
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State | WI
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Zip | 53226-1415
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Country | US
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Telephone | 414-687-0087
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AYAKO MIZUNO
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Credential | DAOM
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Telephone | 414-687-0087
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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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