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General NPI Number Information
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NPI Number | 1366607863
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Entity Type | Organization
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Legal Business Name | DAINTY ACUPUNCTURE
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 2450 WILSHIRE BLVD SUITE #1
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City | SANTA MONICA
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State | CA
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Zip | 90403-5829
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Country | US
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Telephone | 310-895-3891
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Fax | 310-496-2717
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Provider Business Mailing Address
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Address Line | 2450 WILSHIRE BLVD SUITE #1
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City | SANTA MONICA
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State | CA
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Zip | 90403-5829
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Country | US
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Telephone | 310-895-3891
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Fax | 310-496-2717
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Authorized Official
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Title or Position | LAC, OWNER
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Name | SHELLY DAINTY
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Credential | LAC, MTOM, BS
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Telephone | 310-895-3891
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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 | 11908
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License Number State | CA
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