=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528449584
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILY HURM L.AC., DIPL. O.M.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2015
-----------------------------------------------------
Last Update Date | 06/16/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3408 WOODLAND AVE SUITE #305
-----------------------------------------------------
City | WEST DES MOINES
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50266-6506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-556-3304
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3408 WOODLAND AVE SUITE #305
-----------------------------------------------------
City | WEST DES MOINES
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50266-6506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-556-3304
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | A-83
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------