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General NPI Number Information
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NPI Number | 1497169353
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Entity Type | Organization
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Legal Business Name | ZEN FOR LIFE WELLNESS LLC
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 150 FLANAGAN WAY
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City | SECAUCUS
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State | NJ
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Zip | 07094-3445
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Country | US
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Telephone | 201-298-3112
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Fax |
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Provider Business Mailing Address
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Address Line | 150 FLANAGAN WAY
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City | SECAUCUS
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State | NJ
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Zip | 07094-3445
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Country | US
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Telephone | 201-298-3112
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ELEONORA A BOWERS
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Credential | L.AC.
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Telephone | 619-890-8297
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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 | 25MZ00085400
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License Number State | NJ
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