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General NPI Number Information
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NPI Number | 1144483488
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Entity Type | Organization
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Legal Business Name | 5 SEASONS ACUPUNCTURE INC
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 1928 14TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-3507
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Country | US
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Telephone | 772-539-0240
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Fax |
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Provider Business Mailing Address
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Address Line | 1928 14TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-3507
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Country | US
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Telephone | 772-539-0240
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEXANDER SNODGRESS
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Credential | AP
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Telephone | 772-539-0240
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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 | AP2495
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License Number State | FL
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