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General NPI Number Information
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NPI Number | 1124598727
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Entity Type | Organization
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Legal Business Name | LONNIE ASCHEBROOK ACUPUNCTURE LLC
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Dates
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Enumeration Date | 11/27/2018
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Last Update Date | 10/27/2019
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Provider Practice Location Address
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Address Line | 6900 TAVISTOCK LAKES BLVD STE 400
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City | ORLANDO
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State | FL
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Zip | 32827-7593
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Country | US
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Telephone | 901-376-5198
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Fax |
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Provider Business Mailing Address
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Address Line | 9246 REYMONT ST
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City | ORLANDO
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State | FL
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Zip | 32827-3814
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Country | US
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Telephone | 901-376-5198
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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. LONNIE HENRY ASCHEBROOK
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Credential | DOM, DIPL. O.M, LA.C
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Telephone | 901-376-5198
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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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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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