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General NPI Number Information
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NPI Number | 1326308859
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Entity Type | Organization
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Legal Business Name | ANANDA ACUPUNCTURE LLC.
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Dates
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Enumeration Date | 05/17/2012
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Last Update Date | 05/17/2012
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Provider Practice Location Address
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Address Line | 930 E KNAPP ST SUITE 36
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City | MILWAUKEE
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State | WI
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Zip | 53202-2896
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Country | US
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Telephone | 414-791-0303
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Fax |
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Provider Business Mailing Address
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Address Line | 930 E KNAPP ST SUITE 36
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City | MILWAUKEE
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State | WI
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Zip | 53202-2896
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Country | US
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Telephone | 414-791-0303
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AUBREY CONTRAMAESTRE
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Credential | C.AC
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Telephone | 414-791-0303
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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 | 748-55
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License Number State | WI
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