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General NPI Number Information
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NPI Number | 1184217804
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Entity Type | Organization
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Legal Business Name | ACUHERB COMMUNITY CIRCLE
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Dates
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Enumeration Date | 02/12/2021
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 22685 THREE NOTCH RD STE 202
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City | CALIFORNIA
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State | MD
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Zip | 20619-3152
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Country | US
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Telephone | 803-517-5019
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Fax |
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Provider Business Mailing Address
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Address Line | 22685 THREE NOTCH RD STE 202
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City | CALIFORNIA
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State | MD
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Zip | 20619-3152
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Country | US
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Telephone | 301-202-4053
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER TAYLOR ONU LEBAKA MENDA
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Credential | LAC
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Telephone | 301-202-5043
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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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