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General NPI Number Information
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NPI Number | 1659757029
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Entity Type | Organization
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Legal Business Name | GREEN ACUPUNCTURE LLC
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Dates
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Enumeration Date | 08/07/2015
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Last Update Date | 08/07/2015
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Provider Practice Location Address
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Address Line | 8198 S JOG RD STE 203
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-6903
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Country | US
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Telephone | 561-244-5424
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Fax |
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Provider Business Mailing Address
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Address Line | 8198 S JOG RD STE 203
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-6903
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Country | US
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Telephone | 561-244-5424
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Fax |
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Authorized Official
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Title or Position | OWNER/SENIOR PARTNER
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Name | DAVID JAMES GREEN
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Credential | AP DOM
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Telephone | 561-244-5424
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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 | AP 3526
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License Number State | FL
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