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General NPI Number Information
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NPI Number | 1245700749
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Entity Type | Organization
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Legal Business Name | INNERQI ACUPUNCTURE AND WELLNESS, LLC
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Dates
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Enumeration Date | 11/28/2018
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Last Update Date | 11/28/2018
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Provider Practice Location Address
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Address Line | 5654 W BELL RD
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City | GLENDALE
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State | AZ
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Zip | 85308-3882
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Country | US
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Telephone | 520-354-0028
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Fax |
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Provider Business Mailing Address
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Address Line | 15164 N 140TH DR APT 3128
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City | SURPRISE
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State | AZ
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Zip | 85379-8592
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Country | US
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Telephone | 708-609-7709
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Fax |
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Authorized Official
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Title or Position | MEMBER/ORGANIZER
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Name | RAMONA GOLDMAN
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Credential |
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Telephone | 520-354-0028
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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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