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General NPI Number Information
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NPI Number | 1598064768
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Entity Type | Organization
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Legal Business Name | ADCOCK ACUPUNCTURE & CHINESE MEDICAL ARTS, LLC
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Dates
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Enumeration Date | 03/26/2011
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Last Update Date | 03/26/2011
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Provider Practice Location Address
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Address Line | 3 DUNWOODY PARK SUITE 126
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City | DUNWOODY
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State | GA
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Zip | 30338-7405
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Country | US
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Telephone | 770-853-7002
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Fax |
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Provider Business Mailing Address
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Address Line | 3787 HARTS MILL CT
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City | ATLANTA
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State | GA
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Zip | 30341-1730
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Country | US
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Telephone | 770-853-7002
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/PRESIDENT
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Name | KIMBERLY B. ADCOCK
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Credential | L.AC.
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Telephone | 770-853-7002
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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 | 000185
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 000139
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License Number State | GA
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