=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174077986
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOW FAMILY ACUPUNCTURE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/09/2016
-----------------------------------------------------
Last Update Date | 10/03/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6000 FAIRWAY DR STE 7
-----------------------------------------------------
City | ROCKLIN
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95677-4244
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-723-5008
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6000 FAIRWAY DR STE 7
-----------------------------------------------------
City | ROCKLIN
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95677-4244
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | AUSTIN LOW
-----------------------------------------------------
Credential | LAC.
-----------------------------------------------------
Telephone | 916-475-8696
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 17036
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 17037
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------