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General NPI Number Information
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NPI Number | 1487807475
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Entity Type | Organization
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Legal Business Name | INTEGRAL ACUPUNCTURE
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Dates
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Enumeration Date | 11/04/2008
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 636 EASTON AVE
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City | SOMERSET
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State | NJ
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Zip | 08873-1975
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Country | US
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Telephone | 732-545-3800
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Fax | 732-545-3801
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Provider Business Mailing Address
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Address Line | 636 EASTON AVE
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City | SOMERSET
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State | NJ
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Zip | 08873-1975
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Country | US
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Telephone | 732-545-3800
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Fax | 732-545-3801
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Authorized Official
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Title or Position | CERTIFIED ACUPUNCTURIST/OWNER
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Name | JOANNA JODAR
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Credential | CA
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Telephone | 732-545-3800
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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 | 25MZ00045600
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License Number State | NJ
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