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General NPI Number Information
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NPI Number | 1619766946
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Entity Type | Organization
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Legal Business Name | LOUISVILLE FAMILY ACUPUNCTURE
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 4156 WESTPORT RD STE 103
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City | LOUISVILLE
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State | KY
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Zip | 40207-2705
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Country | US
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Telephone | 502-509-2407
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Fax |
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Provider Business Mailing Address
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Address Line | 4156 WESTPORT RD STE 103
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City | LOUISVILLE
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State | KY
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Zip | 40207-2705
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Country | US
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Telephone | 615-894-5086
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Fax |
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Authorized Official
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Title or Position | LICENSED ACUPUNCTURIST
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Name | ALEXANDRA MACIAS
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Credential | LAC
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Telephone | 615-894-5086
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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 |
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License Number State |
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