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General NPI Number Information
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NPI Number | 1184227225
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Entity Type | Organization
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Legal Business Name | PANDA ACUPUNCTURE CLINIC
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Dates
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Enumeration Date | 11/20/2020
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Last Update Date | 11/20/2020
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Provider Practice Location Address
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Address Line | 1511 S HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43207-1832
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Country | US
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Telephone | 614-354-9101
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Fax |
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Provider Business Mailing Address
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Address Line | 1511 S HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43207-1832
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Country | US
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Telephone | 614-354-9101
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Fax |
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Authorized Official
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Title or Position | OWNER/PRIMARY PRACTICIONER
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Name | TERRY M BLANKENSHIP
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Credential | LMT, L. AC.
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Telephone | 614-354-9101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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