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General NPI Number Information
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NPI Number | 1396089579
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Entity Type | Organization
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Legal Business Name | KUNLUN MOUNTAIN ACUPUNCTURE, INC.
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Dates
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Enumeration Date | 11/12/2012
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Last Update Date | 11/12/2012
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Provider Practice Location Address
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Address Line | 803 207TH ST
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City | PASADENA
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State | MD
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Zip | 21122-1631
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Country | US
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Telephone | 410-627-3387
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Fax |
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Provider Business Mailing Address
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Address Line | 803 207TH ST
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City | PASADENA
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State | MD
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Zip | 21122-1631
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRACY SOLTESZ
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Credential | L.AC.
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Telephone | 410-627-3387
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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 | U-01512
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License Number State | MD
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