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General NPI Number Information
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NPI Number | 1295005148
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Entity Type | Organization
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Legal Business Name | WHITE CRANE HEALING ARTS CENTER, INC.
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 7071 W COMMERCIAL BLVD SUITE 2C
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City | LAUDERHILL
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State | FL
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Zip | 33319-2143
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Country | US
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Telephone | 954-721-7252
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Fax |
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Provider Business Mailing Address
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Address Line | 7071 W COMMERCIAL BLVD SUITE 2C
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City | LAUDERHILL
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State | FL
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Zip | 33319-2143
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Country | US
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Telephone | 954-721-7252
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT - OWNER
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Name | MR. FRANK IBORRA
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Credential | D.O.M.
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Telephone | 954-721-7252
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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 | AP460
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License Number State | FL
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