=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497177463
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRANQUIL PATH ACUPUNCTURE & HEALING ARTS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/10/2014
-----------------------------------------------------
Last Update Date | 01/10/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1245 S CEDAR CREST BLVD STE 202
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18103-6258
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-653-0310
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5475 HAMILTON BLVD TRLR 30
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18106-9199
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-653-0310
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ROCHELLE AUBERT
-----------------------------------------------------
Credential | LAC
-----------------------------------------------------
Telephone | 610-653-0310
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AK001041
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------