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General NPI Number Information
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NPI Number | 1316418254
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Entity Type | Organization
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Legal Business Name | ARROWHEAD ACUPUNCTURE
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 12/17/2018
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Provider Practice Location Address
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Address Line | 29099 HOSPITAL RD SUITE 112 B
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City | LAKE ARROWHEAD
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State | CA
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Zip | 92352
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Country | US
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Telephone | 909-485-1616
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3507
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City | LAKE ARROWHEAD
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State | CA
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Zip | 92352-3507
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Country | US
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Telephone | 909-485-1616
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. THOMAS CHARLES FLACH JR.
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Credential | L.AC.
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Telephone | 858-761-7432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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