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General NPI Number Information
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NPI Number | 1255739629
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Entity Type | Organization
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Legal Business Name | HEALING RIVERS ACUPUNCTURE AND COMMUNITY CENTER
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Dates
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Enumeration Date | 12/16/2014
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Last Update Date | 12/16/2014
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Provider Practice Location Address
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Address Line | 1110 W SAN ANTONIO ST
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-5510
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Country | US
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Telephone | 830-627-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 W SAN ANTONIO ST
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-5510
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Country | US
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Telephone | 830-627-1111
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | DIANE CELESTE KING
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Credential | L. AC.
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Telephone | 830-627-1111
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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 | 1530
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License Number State | TX
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