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General NPI Number Information
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NPI Number | 1619200797
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Entity Type | Organization
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Legal Business Name | ALOHA WELLNESS CORPORATION
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Dates
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Enumeration Date | 09/08/2009
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Last Update Date | 11/16/2011
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Provider Practice Location Address
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Address Line | 4933 AUBURN AVE 207-C
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City | BETHESDA
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State | MD
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Zip | 20814-2631
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Country | US
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Telephone | 301-493-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 3243 HUMMINGBIRD LN
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City | HIAWASSEE
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State | GA
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Zip | 30546-1537
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Country | US
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Telephone | 706-896-3300
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Fax | 706-896-1050
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | DESTINI Z. ADAMZ
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Credential | LMT
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Telephone | 706-896-3300
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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 | U00160
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License Number State | MD
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