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General NPI Number Information
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NPI Number | 1588176903
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Entity Type | Organization
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Legal Business Name | WINDHORSE ACUPUNCTURE
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 10/25/2017
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Provider Practice Location Address
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Address Line | 107 HAND AVE SUITE 4B
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City | ELIZABETHTOWN
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State | NY
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Zip | 12932
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Country | US
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Telephone | 518-524-1141
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1624
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City | LAKE PLACID
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State | NY
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Zip | 12946-5624
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Country | US
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Telephone | 518-524-1141
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST/ OWNER
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Name | CHRISTINA ANNE HABEREK- WINDHORSE
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Credential | LIC. AC
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Telephone | 518-524-1141
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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 | 004260-1
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License Number State | NY
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