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General NPI Number Information
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NPI Number | 1265205801
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Entity Type | Organization
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Legal Business Name | FERTILE TURTLE ACUPUNCTURE INC
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Dates
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Enumeration Date | 11/06/2023
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 409 CAMINO DEL RIO S SUITE 110
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City | SAN DIEGO
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State | CA
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Zip | 92108
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Country | US
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Telephone | 619-980-4631
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Fax |
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Provider Business Mailing Address
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Address Line | 750 CREST DRIVE
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City | ENCINITAS
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State | CA
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Zip | 92024
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Country | US
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Telephone | 619-560-9758
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LORI A WILSON
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Credential | L.AC.
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Telephone | 619-560-9758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #2
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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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