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General NPI Number Information
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NPI Number | 1306145529
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Entity Type | Organization
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Legal Business Name | GOOD MEDICINE ACUPUNCTURE SERVICES, LLC
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Dates
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Enumeration Date | 03/28/2011
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 7051 CYPRESS TER SUITE 206
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City | FORT MYERS
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State | FL
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Zip | 33907-8822
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Country | US
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Telephone | 239-826-8535
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Fax |
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Provider Business Mailing Address
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Address Line | 7051 CYPRESS TER SUITE 206
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City | FORT MYERS
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State | FL
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Zip | 33907-8822
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Country | US
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Telephone | 239-826-8535
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURE PHYSICIAN
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Name | DOMINIC A LEOTTI
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Credential | AP, DOM
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Telephone | 239-826-8535
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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 | AP2844
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License Number State | FL
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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 | AP2906
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License Number State | FL
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