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General NPI Number Information
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NPI Number | 1215573464
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Entity Type | Organization
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Legal Business Name | SOLARA WELLNESS LLC
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Dates
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Enumeration Date | 11/22/2019
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Last Update Date | 06/29/2020
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Provider Practice Location Address
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Address Line | 644 MIGALDI LN STE 300
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City | LANSING
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State | MI
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Zip | 48917-7758
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Country | US
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Telephone | 517-388-1507
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Fax |
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Provider Business Mailing Address
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Address Line | 644 MIGALDI LN STE 300
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City | LANSING
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State | MI
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Zip | 48917-7758
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Country | US
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Telephone | 517-388-1507
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MOLLY SWEET
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Credential |
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Telephone | 517-388-1507
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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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