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General NPI Number Information
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NPI Number | 1477913309
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE PAIN AND STRESS CENTER, LLC
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 100 E SIX FORKS RD SUITE 320
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City | RALEIGH
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State | NC
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Zip | 27609-7752
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Country | US
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Telephone | 919-260-4104
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Fax | 919-400-4232
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Provider Business Mailing Address
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Address Line | 100 E SIX FORKS RD SUITE 320
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City | RALEIGH
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State | NC
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Zip | 27609-7752
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Country | US
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Telephone | 919-260-4104
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Fax | 919-400-4232
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | JAMES ELECZKO
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Credential | LAC.
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Telephone | 919-260-4104
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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 | 577
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License Number State | NC
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