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General NPI Number Information
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NPI Number | 1174349740
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Entity Type | Organization
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Legal Business Name | HAMPTON ACUPUNCTURE & HERB CLINIC LLC
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Dates
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Enumeration Date | 11/28/2024
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Last Update Date | 11/28/2024
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Provider Practice Location Address
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Address Line | 1300 INDUSTRIAL BLVD STE 100A
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City | SOUTHAMPTON
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State | PA
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Zip | 18966-4029
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Country | US
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Telephone | 215-909-0692
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Fax |
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Provider Business Mailing Address
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Address Line | 226 SUSAN DR
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City | ELKINS PARK
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State | PA
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Zip | 19027-1833
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ACUPUNCTURIST
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Name | MARTA DIDUKH
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Credential |
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Telephone | 215-909-0692
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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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