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General NPI Number Information
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NPI Number | 1639847734
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Entity Type | Organization
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Legal Business Name | CLARITY ACUPUNCTURE
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 827 GLENSIDE AVE STE C
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City | WYNCOTE
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State | PA
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Zip | 19095-1221
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Country | US
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Telephone | 267-690-0795
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Fax |
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Provider Business Mailing Address
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Address Line | 624 BRIDLE RD
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City | GLENSIDE
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State | PA
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Zip | 19038-2004
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Country | US
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Telephone | 267-690-0795
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE SUPSIC
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Credential | LAC
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Telephone | 267-690-0795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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