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General NPI Number Information
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NPI Number | 1477715993
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Entity Type | Organization
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Legal Business Name | EASTERN MEDICINE HEALTH CENTER
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 280 PATTERSON RD STE.# 1
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City | HAINES CITY
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State | FL
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Zip | 33844-6261
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Country | US
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Telephone | 863-421-2900
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Fax | 863-421-2990
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Provider Business Mailing Address
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Address Line | 280 PATTERSON RD STE.# 1
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City | HAINES CITY
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State | FL
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Zip | 33844-6261
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Country | US
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Telephone | 863-421-2900
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Fax | 863-421-2990
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | LAN WANG
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Credential |
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Telephone | 863-421-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | LMT 42039
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP 2523
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License Number State | FL
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