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General NPI Number Information
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NPI Number | 1164899209
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Entity Type | Organization
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Legal Business Name | MPET INC
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 08/24/2015
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Provider Practice Location Address
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Address Line | 50 E MAIN AVE SUITE C
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City | MORGAN HILL
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State | CA
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Zip | 95037-3661
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Country | US
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Telephone | 408-782-8500
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Fax | 408-782-5199
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Provider Business Mailing Address
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Address Line | 50 E MAIN AVE SUITE C
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City | MORGAN HILL
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State | CA
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Zip | 95037-3661
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Country | US
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Telephone | 408-782-8500
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Fax | 408-782-5199
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Authorized Official
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Title or Position | CEO
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Name | DR. MICHELLE SWANSON
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Credential | DAOM LAC PHD
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Telephone | 408-710-6298
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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 | AC14998
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 173C00000X
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Taxonomy Name | Reflexologist
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License Number | AC15353
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A96792
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License Number State | CA
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