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General NPI Number Information
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NPI Number | 1356745624
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Entity Type | Organization
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Legal Business Name | MINDY ROHRBACHER DBA RADIANT LIFE ACUPUNCTURE, LLC
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Dates
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Enumeration Date | 10/15/2014
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 3463 NW 13TH ST STE C
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City | GAINESVILLE
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State | FL
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Zip | 32609-2172
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Country | US
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Telephone | 352-362-7615
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Fax | 888-837-2955
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Provider Business Mailing Address
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Address Line | 3463 NW 13TH ST STE C
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City | GAINESVILLE
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State | FL
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Zip | 32609-2172
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Country | US
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Telephone | 352-362-7615
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Fax | 888-837-2955
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Authorized Official
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Title or Position | OWNER
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Name | MINDY ROHRBACHER
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Credential | LMHC, AP
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Telephone | 352-362-7615
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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 | AP3115
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License Number State | FL
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