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General NPI Number Information
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NPI Number | 1275904161
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Entity Type | Organization
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Legal Business Name | TAMPA TOP ACUPUNCTURE & HERBS LLC
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Dates
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Enumeration Date | 10/18/2015
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Last Update Date | 04/13/2016
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Provider Practice Location Address
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Address Line | 2253 GREEN HEDGES WAY STE 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6969
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Country | US
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Telephone | 813-334-9694
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Fax |
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Provider Business Mailing Address
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Address Line | 1830 MONTGOMERY BELL RD
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-7188
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Country | US
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Telephone | 813-334-9694
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DONGCHEUL KANG
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Credential |
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Telephone | 813-334-9694
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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 | AP3615
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License Number State | FL
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