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General NPI Number Information
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NPI Number | 1699438259
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Entity Type | Organization
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Legal Business Name | TWELVE RIVERS ACUPUNCTURE, PC
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 176 MOUNTAIN AVE STE 2B
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City | HACKETTSTOWN
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State | NJ
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Zip | 07840-2434
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Country | US
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Telephone | 908-850-1400
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Fax | 908-852-1402
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Provider Business Mailing Address
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Address Line | 261 BLACK RIVER RD
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City | LONG VALLEY
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State | NJ
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Zip | 07853-3067
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Country | US
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Telephone | 646-691-7482
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Fax | 908-852-1402
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Authorized Official
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Title or Position | OWNER
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Name | MS. BETH LEATHERMAN
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Credential | L.AC
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Telephone | 646-691-7482
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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 |
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License Number State |
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