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General NPI Number Information
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NPI Number | 1396213658
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Entity Type | Organization
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Legal Business Name | WIND POINT ACUPUNCTURE LLC.
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Dates
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Enumeration Date | 11/05/2018
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Last Update Date | 11/05/2018
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Provider Practice Location Address
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Address Line | 4060 N MAIN ST STE 106
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City | RACINE
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State | WI
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Zip | 53402-3121
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Country | US
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Telephone | 262-635-0525
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Fax | 262-639-0524
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Provider Business Mailing Address
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Address Line | 4060 N MAIN ST STE 106
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City | RACINE
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State | WI
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Zip | 53402-3121
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Country | US
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Telephone | 262-635-0525
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Fax | 262-639-0524
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Authorized Official
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Title or Position | SOLE MEMBER LLC
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Name | MRS. STEPHANIE LYNN SMITH-WHYBARK
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Credential | RN, L.AC
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Telephone | 262-635-0525
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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 |
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License Number State |
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