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General NPI Number Information
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NPI Number | 1689175044
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Entity Type | Organization
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Legal Business Name | HOLISTIC HEALTH ON THE GO, INC.
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 05/04/2025
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Provider Practice Location Address
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Address Line | 304 NW BETHANY DR
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-3578
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Country | US
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Telephone | 772-353-1397
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Fax |
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Provider Business Mailing Address
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Address Line | 2706 N POWNAL RD
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City | POWNAL
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State | VT
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Zip | 05261-9625
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Country | US
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Telephone | 772-353-1397
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF ACUPUNCTURE AND ORIENTAL
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Name | RACHELLE TETREAULT
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Credential | DAOM, L,AC
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Telephone | 772-353-1397
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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 | 3872
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License Number State | FL
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