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General NPI Number Information
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NPI Number | 1689125130
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Entity Type | Organization
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Legal Business Name | SLOWPOKE ACUPUNCTURE
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Dates
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Enumeration Date | 10/19/2016
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 3150 18TH ST STE 547
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-2074
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Country | US
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Telephone | 415-412-1497
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Fax |
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Provider Business Mailing Address
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Address Line | 2921 FOLSOM ST APT A
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-4027
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Country | US
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Telephone | 415-412-1497
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR/ACUPUNCTURIST
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Name | TARA SPALTY
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Credential | LAC
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Telephone | 415-412-1497
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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 | 16489
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License Number State | CA
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