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General NPI Number Information
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NPI Number | 1568979128
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Entity Type | Organization
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Legal Business Name | LIGHTER ACUPUNCTURE & INTEGRATIVE HEALTH INC
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Dates
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Enumeration Date | 01/04/2018
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Last Update Date | 01/04/2018
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Provider Practice Location Address
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Address Line | 43 CORPORATE PARK STE 204
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City | IRVINE
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State | CA
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Zip | 92606-5137
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Country | US
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Telephone | 949-546-7865
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Fax |
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Provider Business Mailing Address
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Address Line | 15212 HENRY WAY
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City | TUSTIN
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State | CA
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Zip | 92782-1766
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | RACHEL RYCHLOCK
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Credential | L.AC.
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Telephone | 949-546-7865
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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 | 16962
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License Number State | CA
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