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General NPI Number Information
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NPI Number | 1275846834
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Entity Type | Organization
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Legal Business Name | BARKSTROM ACUPUNCTURE PC
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Dates
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Enumeration Date | 07/23/2010
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Last Update Date | 07/23/2010
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Provider Practice Location Address
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Address Line | 500 PINE ST
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City | JAMESTOWN
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State | NY
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Zip | 14701-5384
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Country | US
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Telephone | 716-665-5015
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Fax | 402-260-7158
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Provider Business Mailing Address
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Address Line | 500 PINE ST
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City | JAMESTOWN
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State | NY
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Zip | 14701-5384
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Country | US
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Telephone | 716-665-5015
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Fax | 402-260-7158
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Authorized Official
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Title or Position | CEO
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Name | JEFFREY R BARKSTROM
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Credential | LAC
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Telephone | 716-665-5015
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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 | 003252-1
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License Number State | NY
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