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General NPI Number Information
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NPI Number | 1629371075
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE AND MASSAGE OF WESTERN NEW YORK PC
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 6003 BIG TREE RD
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City | LAKEVILLE
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State | NY
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Zip | 14480-9753
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Country | US
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Telephone | 585-346-4510
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Fax | 585-346-4510
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Provider Business Mailing Address
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Address Line | 6003 BIG TREE RD
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City | LAKEVILLE
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State | NY
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Zip | 14480-9753
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Country | US
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Telephone | 585-346-4510
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Fax | 585-346-4510
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN CLAYTON LINK
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Credential | L.A.C., L.M.T.
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Telephone | 585-346-4510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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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 |
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License Number State |
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