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General NPI Number Information
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NPI Number | 1295158384
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Entity Type | Organization
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Legal Business Name | BEACHES ACUPUNCTURE & WELLNESS CENTER
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 504 OSCEOLA AVE
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4030
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Country | US
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Telephone | 904-853-5592
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Fax |
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Provider Business Mailing Address
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Address Line | 504 OSCEOLA AVE
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4030
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Country | US
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Telephone | 904-853-5592
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | RACHEL BUCHANAN
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Credential | AP, DIPL. OM
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Telephone | 904-853-5592
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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 | AP3378
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License Number State | FL
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