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General NPI Number Information
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NPI Number | 1245633346
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Entity Type | Organization
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Legal Business Name | ASCEND ACUPUNCTURE
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 243 GLENNORA WAY
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City | BUELLTON
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State | CA
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Zip | 93427
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Country | US
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Telephone | 805-895-1164
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Fax |
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Provider Business Mailing Address
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Address Line | 270 E HIGHWAY 246 STE 222
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City | BUELLTON
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State | CA
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Zip | 93427-9677
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Country | US
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Telephone | 805-895-1164
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAWN WAFER
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Credential |
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Telephone | 805-895-1164
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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 | AC 11733
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License Number State | CA
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