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General NPI Number Information
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NPI Number | 1215073408
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Entity Type | Organization
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Legal Business Name | BALANCED HEALTH ACUPUNCTURE
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7618 37TH STREET CIR E
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City | SARASOTA
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State | FL
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Zip | 34243-3400
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Country | US
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Telephone | 941-504-4280
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Fax |
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Provider Business Mailing Address
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Address Line | 7618 37TH STREET CIR E
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City | SARASOTA
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State | FL
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Zip | 34243-3400
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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 | DOCTOR OF ORIENTAL MEDICINE
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Name | JOSHUA O'DEA
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Credential | A.P., D.O.M.
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Telephone | 941-504-4280
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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 | 2066
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License Number State | FL
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