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General NPI Number Information
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NPI Number | 1548772445
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Entity Type | Organization
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Legal Business Name | NURTURING LIFE ACUPUNCTURE & WELLNESS PA
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Dates
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Enumeration Date | 11/01/2017
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Last Update Date | 12/06/2017
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Provider Practice Location Address
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Address Line | 106 4TH ST
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City | HOBOKEN
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State | NJ
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Zip | 07030-4837
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Country | US
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Telephone | 201-526-4684
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Fax |
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Provider Business Mailing Address
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Address Line | 600 HUDSON ST APT 2C
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City | HOBOKEN
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State | NJ
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Zip | 07030-5925
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Country | US
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Telephone | 706-934-5247
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILLIAM R WRIGHT JR.
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Credential | LAC
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Telephone | 706-934-5247
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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 | 25MZ00122000
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License Number State | NJ
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